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Han MA, Storman D, Al-Rammahy H, Tang S, Hao Q, Leung G, Kandi M, Moradi R, Bartoszko JJ, Arnold C, Rehman N, Guyatt G. Impact of maternal reproductive factors on cancer risks of offspring: A systematic review and meta-analysis of cohort studies. PLoS One 2020; 15:e0230721. [PMID: 32226046 PMCID: PMC7105118 DOI: 10.1371/journal.pone.0230721] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/06/2020] [Indexed: 02/05/2023] Open
Abstract
Background A number of studies have reported on associations between reproductive factors, such as delivery methods, number of birth and breastfeeding, and incidence of cancer in children, but systematic reviews addressing this issue to date have important limitations, and no reviews have addressed the impact of reproductive factors on cancer over the full life course of offspring. Methods We performed a comprehensive search in MEDLINE, and Embase up to January 2020 and Web of Science up to 2018 July, including cohort studies reporting the association between maternal reproductive factors of age at birth, birth order, number of births, delivery methods, and breastfeeding duration and cancer in children. Teams of two reviewers independently extracted data and assessed risk of bias. We conducted random effects meta-analyses to estimate summary relative estimates, calculated absolute differences between those with and without risk factors, and used the GRADE approach to evaluate the certainty of evidence. Results For most exposures and most cancers, we found no suggestion of a causal relation. We found low to very low certainty evidence of the following very small possible impact: higher maternal age at birth with adult multiple myeloma and lifetime uterine cervix cancer incidence; lower maternal age at birth with childhood overall cancer mortality (RR = 1.15, 95% CI = 1.01–1.30; AR/10,000 = 1, 95% CI = 0 to 2), adult leukemia and lifetime uterine cervix cancer incidence; higher birth order with adult melanoma, cervix uteri, corpus uteri, thyroid cancer incidence, lifetime lung, corpus uteri, prostate, testis, sarcoma, thyroid cancer incidence; larger number of birth with childhood brain (RR = 1.27, 95% CI = 1.06–1.52; AR/10,000 = 1, 95% CI = 0 to 2), leukemia (RR = 2.11, 95% CI = 1.62–2.75; AR/10,000 = 9, 95% CI = 5 to 14), lymphoma (RR = 4.66, 95% CI = 1.40–15.57; AR/10,000 = 11, 95% CI = 1 to 44) incidence, adult stomach, corpus uteri cancer incidence and lung cancer mortality, lifetime stomach, lung, uterine cervix, uterine corpus, multiple myeloma, testis cancer incidence; Caesarean delivery with childhood kidney cancer incidence (RR = 1.25, 95% CI = 1.01–1.55; AR/10,000 = 0, 95% CI = 0 to 1); and breastfeeding with adult colorectal cancer incidence. Conclusion Very small impacts existed between a number of reproductive factors and cancer incidence and mortality in children and the certainty of evidence was low to very low primarily due to observational design.
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Affiliation(s)
- Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
- * E-mail:
| | - Dawid Storman
- Department of Hygiene and Dietetics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Husam Al-Rammahy
- Life Sciences—Department of Biomedical and Molecular Sciences, Queen's University at Kingston, Kingston, Canada
| | - Shaowen Tang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qiukui Hao
- The center of Gerontology and Geriatrics, National Center for Geriatric Clinical Research, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Gareth Leung
- Department of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Maryam Kandi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Romina Moradi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jessica J. Bartoszko
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Callum Arnold
- Division of Infectious Diseases, the Hospital for Sick Children, Toronto, Canada
| | - Nadia Rehman
- Department of Continuing Education, McMaster University, Hamilton, Canada
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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Yang TO, Cairns BJ, Green J, Reeves GK, Floud S, Bradbury KE, Beral V. Adult cancer risk in women who were breastfed as infants: large UK prospective study. Eur J Epidemiol 2019; 34:863-870. [PMID: 31187313 PMCID: PMC6759744 DOI: 10.1007/s10654-019-00528-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/22/2019] [Indexed: 01/26/2023]
Abstract
There are known short-term benefits in breastfed infants versus bottle-fed infants in terms of lower risks of infection and obesity in infancy and childhood, but the long-term effect on the risk of adult cancers is unclear. In a cohort of 1 in 4 UK women born in 1935-1950 we report the incidence of adult cancers in relation to having been breastfed in infancy. In median year 2001 (interquartile range 2000-2003) 548,741 women without prior cancer reported whether they had been breastfed. There was 81% agreement between women's report of having been breastfed and information on breastfeeding recorded when they were 2 years old. Participants were followed by record-linkage to national cancer registration, hospital admission and death databases. Cox regression yielded adjusted relative risks (RRs) and 95% confidence intervals (CI) by having been breastfed or not for eight cancer sites with > 2000 incident cases and for related conditions, where appropriate. Of the eight cancers examined here one association was highly statistically significant: an increase in colorectal cancer incidence among women who had been breastfed versus not (RR 1.18, 95% CI 1.12-1.24, n = 8651). To investigate further the findings for colorectal cancer, we studied eight other gastro-intestinal conditions, and found increased risks in women who had been breastfed versus not for benign colorectal polyps (RR 1.09, 95% CI 1.05-1.13, n = 17,677) and for appendicitis (RR 1.19, 95% CI 1.07-1.31, n = 2108). The greater risks of adult colorectal cancer, colorectal polyps and appendicitis associated with having been breastfed in infancy suggest possible long-term effects of infant feeding practices on the gastrointestinal tract. Further studies are required to clarify this novel association.
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Affiliation(s)
- TienYu Owen Yang
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Benjamin J Cairns
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Jane Green
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Gillian K Reeves
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Sarah Floud
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Kathryn E Bradbury
- National Institute for Health Innovation, School of Public Health, University of Auckland, Level 4, Tamaki Campus, 261 Morrin Road, Glen Innes, Auckland, 1072, New Zealand
| | - Valerie Beral
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
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Wang L, Li J, Shi Z. Association between Breastfeeding and Endometrial Cancer Risk: Evidence from a Systematic Review and Meta-Analysis. Nutrients 2015; 7:5697-711. [PMID: 26184301 PMCID: PMC4517025 DOI: 10.3390/nu7075248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/01/2015] [Accepted: 07/03/2015] [Indexed: 11/24/2022] Open
Abstract
Quantification of the association between breastfeeding and risk of endometrial cancer is still conflicting. We therefore conducted a meta-analysis to assess the association between breastfeeding and endometrial cancer risk. Pertinent studies were identified by a search of PubMed and Web of Knowledge through April 2015. A random effect model was used to combine the data for analysis. Sensitivity analysis and publication bias were conducted. Dose-response relationships were assessed by restricted cubic spline and variance-weighted least squares regression analysis. Fourteen articles involving 5158 endometrial cancer cases and 706,946 participants were included in this meta-analysis. Pooled results suggested that breastfeeding significantly reduced the risk of endometrial cancer (summary relative risk (RR): 0.77, 95% CI: 0.62–0.96, I2: 63.0%), especially in North America (summary RR: 0.87, 95% CI: 0.79–0.95). A linear dose-response relationship was found, with the risk of endometrial cancer decreased by 2% for every one-month increase in the duration of breastfeeding (summary RR: 0.98, 95% CI: 0.97–0.99). Our analysis suggested that breastfeeding, particularly a longer duration of breastfeeding, was inversely associated with the risk of endometrial cancer, especially in North America, but not in Europe and Asia, probably due to the small number of cases included. Due to this limitation, further studies originating in other countries are required to assess the association between breastfeeding and endometrial cancer risk.
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Affiliation(s)
- Lianlian Wang
- Department of Obstetrics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China.
| | - Jingxi Li
- Department of Obstetrics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China.
| | - Zhan Shi
- Department of Obstetrics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China.
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Lactation pattern and the risk for hormone-related female cancer in Japan: the Ohsaki Cohort Study. Eur J Cancer Prev 2013; 22:187-92. [PMID: 23358107 DOI: 10.1097/cej.0b013e3283564610] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Although breastfeeding is associated with a reduction in the risk for breast cancer, its relationship with another hormone-related female cancer, endometrial cancer, has not been fully investigated. The objective of the present study was to prospectively examine the association between lactation pattern and the risk for incidence of breast cancer and endometrial cancer in Japanese women. We analyzed data for 26 680 women registered in the Ohsaki National Health Insurance Cohort Study, who were 40-79 years old at the baseline. During the 11 years of follow-up, we identified 148 incident cases of breast cancer and 32 incident cases of endometrial cancer. Compared with breastfeeding only, multivariate hazard ratios and 95% confidence intervals for the risk of breast cancer incidence were 1.12 (0.92-1.37) for women who had performed mixed feeding and 1.80 (1.14-2.86) for those who fed their babies only with formula (P-trend=0.014). For endometrial cancer incidence, multivariate hazard ratios and 95% confidence intervals were 1.32 (0.86-2.03) for women who had performed mixed feeding and 3.26 (1.23-8.61) for those who had performed only formula feeding (P-trend=0.018). Our findings appear to raise the possibility that nonbreastfeeding is positively associated with the risks for both breast cancer incidence and endometrial cancer incidence. Confirmation of our findings would require further investigation.
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