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Prehn and West, using 1990 census data, calculated breast cancer incidence rates for aggregations of census block groups matched to Marin County on characteristics associated with higher breast cancer risk (percentage white population, urban status, average parity, median household income, percentage of persons with a college degree, percentage of persons with a working-class occupation, and percentage of households living below the poverty line), and found rates in the matched areas to be comparable with those in Marin County [ 4 ] . In another study using interview-based information, higher breast cancer incidence rates among white women in the SFBA were also fully explained by the distribution of parity, age at first birth, months of breast-feeding, age at menarche, and age at menopause [ 5 ] . Other previous analyses of nationwide variation in breast cancer incidence and mortality found most of it attributable to the distribution of known breast cancer risk factors [ 15 16 ] . It thus seems likely that a substantial part of the excess incidence observed in Marin County is explained by a higher concentration of women with a higher breast cancer risk profile.