Chinese Journal of Cancer Research

, Volume 24, Issue 1, pp 9–17

Attributable causes of breast cancer and ovarian cancer in China: Reproductive factors, oral contraceptives and hormone replacement therapy

Original Article

DOI: 10.1007/s11670-012-0009-y

Cite this article as:
Li, L., Ji, J., Wang, J. et al. Chin. J. Cancer Res. (2012) 24: 9. doi:10.1007/s11670-012-0009-y



To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors (RFs, including nulliparity, mean number of children, age at first birth and breastfeeding), use of oral contraceptives (OCs, restricted to the age group of 15–49 years), and hormone replacement therapy (HRT), as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005.


We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China. In the case of RFs, we compared the exposure distributions in 2001 and counterfactual exposure.


Exposure of RFs in 2001 was found to account for 6.74% of breast cancer, corresponding to 9,617 cases and 2,769 deaths, and for 2.78% of ovarian cancer (711 cases, 294 deaths). The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer. The prevalence of OC use was 1.74% and the population attributable fraction (PAF) of breast cancer was 0.71%, corresponding to 310 cases and 90 deaths. The PAF of breast cancer due to HRT was 0.31%, resulting in 297 cases and 85 deaths.


RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.

Key words

Reproductive factorsOral contraceptivesHormone replacement therapyCancerPopulation attributable fraction

Copyright information

© Chinese Anti-Cancer Association and Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Gynecologythe People’s Hospital of Xinjiang Uygur Autonomous RegionUrumqiChina
  2. 2.Department of Cancer Epidemiology, Cancer InstituteChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
  3. 3.Division of Pharmaceutics, College of Pharmacythe Ohio State UniversityColumbusUSA
  4. 4.Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic MedicinePeking Union Medical CollegeBeijingChina
  5. 5.The Tisch Cancer InstituteMount Sinai School of MedicineNew YorkUSA
  6. 6.International Prevention Research InstituteLyonFrance