Cancer Causes & Control

, Volume 17, Issue 10, pp 1275–1280 | Cite as

Induced abortions and the risk of all cancers combined and site-specific cancers in Shanghai

  • Karin A. Rosenblatt
  • Dao L. Gao
  • Roberta M. Ray
  • Michelle R. Rowland
  • Zakia C. Nelson
  • Karen J. Wernli
  • Wenjin Li
  • David B. Thomas
Original Paper


Although some previous case–control studies found an increased risk of breast cancer in women who had an induced abortion, the evidence from prospective studies suggests that induced abortions do not cause breast cancer. We have assessed risks of 12 types of cancer in women who have had induced abortions in a prospective study in China. Female textile workers (n = 267,400) completed a baseline questionnaire (1989–1991) that ascertained information on the major risk factors for breast cancer, contraceptive use, and induced abortions and were actively followed until July 2000. Cox Proportional Hazards analysis was used to calculate incidence rate ratios for specific types of cancer in women who ever had an induced abortion and by number of induced abortions. Women who had had an abortion were not at increased risk of cancer. There was a significant reduction in risk of uterine corpus cancer in women who had ever had an induced abortion, and a significant decreasing trend in risk with increasing number of induced abortions. No convincing associations with other cancers were observed. Women who have induced abortions after a live birth are not at increased risk of cancer and induced abortions may reduce risk of cancer of the corpus uteri.


Neoplasms Abortions, Induced Cohort studies 



This work was supported by National Cancer Institute grants R03-CA80637, R01-CA46823, and R01-CA80180. Earlier findings from this study were presented at the November 2002 American Public Health Association meeting.


  1. 1.
    Peto R, Reeves G (2004) Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83,000 women with breast cancer from 16 countries. Lancet 363:1007–1016PubMedCrossRefGoogle Scholar
  2. 2.
    Ye Z, Gao DL, Qin Q, Ray RM, Thomas DB (2002) Breast cancer in relation to induced abortions in a cohort of Chinese women. Br J Cancer 87:977–981PubMedCrossRefGoogle Scholar
  3. 3.
    Thomas DB, Gao DL, Ray RM, et al. (2002) Randomized trial of breast self-examination in Shanghai: final results. J Natl Cancer Inst 94:1445–1457PubMedGoogle Scholar
  4. 4.
    Parkin DM, Whelan SL, Ferlay J, Toppo L, Thomas DB (eds) (2003) Cancer Incidence in Five Continents, Vol VIII. IARC Sci Publ No 155. Lyon, FranceGoogle Scholar
  5. 5.
    Breslow NE, Day NE (1987) Statistical methods in cancer research. Volume II—The design and analysis of cohort studies. IARC Sci Publ 82:1–406Google Scholar
  6. 6.
    Xiao B, Wang M (1983) Birth control techniques in China. China Popul Newslett 1:1–7Google Scholar
  7. 7.
    McPherson CP, Sellers TA, Potter JD, Bostick RM, Folsom AR (1996) Reproductive factors and risk of endometrial cancer. The Iowa Women’s Health Study. Am J Epidemiol 143:1195–1202PubMedGoogle Scholar
  8. 8.
    Parslov M, Lidegaard O, Klintorp S, et al. (2006) Risk factors among young women with endometrial cancer: a Danish case–control study. Am J Obstet Gynecol 182:23–29CrossRefGoogle Scholar
  9. 9.
    Xu WH, Xiang YB, Ruan ZX, et al. (2004) Menstrual and reproductive factors and endometrial cancer risk: results from a population-based case–control study in urban Shanghai. Int J Cancer 108:613–619PubMedCrossRefGoogle Scholar
  10. 10.
    Shu XO, Brinton LA, Zheng W, Gao YT, Fan J, Fraumeni JF Jr (1991) A population-based case–control study of endometrial cancer in Shanghai, China. Int J Cancer 49:38–43PubMedGoogle Scholar
  11. 11.
    Parazzini F, Negri E, La Vecchia C, et al. (1998) Role of reproductive factors on the risk of endometrial cancer. Int J Cancer 76:784–786PubMedCrossRefGoogle Scholar
  12. 12.
    Parazzini F, La Vecchia C, Negri E, Fedele L, Balotta F (1991) Reproductive factors and risk of endometrial cancer. Am J Obstet Gynecol 164:522–527PubMedGoogle Scholar
  13. 13.
    Kalandidi A, Tzonou A, Lipworth L, Gamatsi I, Filippa D, Trichopoulos D (1996) A case–control study of endometrial cancer in relation to reproductive, somatometric, and life-style variables. Oncology 53:354–359PubMedCrossRefGoogle Scholar
  14. 14.
    Brinton LA, Berman ML, Mortel R, et al. (1992) Reproductive, menstrual, and medical risk factors for endometrial cancer: results from a case–control study. Am J Obstet Gynecol 167:1317–1325PubMedGoogle Scholar
  15. 15.
    Che Y, Cleland J (2003) Contraceptive use before and after marriage in Shanghai. Stud Fam Plann 34:44–52PubMedCrossRefGoogle Scholar
  16. 16.
    Thorp JM Jr, Hartmann KE, Shadigian E (2003) Long-term physical and psychological health consequences of induced abortion: review of the evidence. Obstet Gynecol Surv 58:67–79PubMedCrossRefGoogle Scholar
  17. 17.
    Luo L, Wu SZ, Chen XQ, Li MX, Pullum TW (1996) A follow-up study of first trimester induced abortions at hospitals and family planning clinics in Sichuan province, China. Contraception 53:267–273PubMedCrossRefGoogle Scholar
  18. 18.
    ACOG Committee Opinion. Number 285, August 2003 (2003) Induced abortion and breast cancer risk. Obstet Gynecol 102:433–435CrossRefGoogle Scholar
  19. 19.
    Rosenblatt KA, Gao DL, Ray RM, Nelson ZC, Thomas DB (2004) Contraceptive methods and induced abortions and their association with the risk of colon cancer in Shanghai, China. Eur J Cancer 40:590–593PubMedCrossRefGoogle Scholar
  20. 20.
    La Vecchia C, Negri E, Franceschi S, Parazzini F (1993) Long-term impact of reproductive factors on cancer risk. Int J Cancer 53:215–219PubMedGoogle Scholar
  21. 21.
    Talamini R, Franceschi S, Dal Maso L, et al. (1998) The influence of reproductive and hormonal factors on the risk of colon and rectal cancer in women. Eur J Cancer 34:1070–1076PubMedCrossRefGoogle Scholar
  22. 22.
    La Vecchia C, Negri E, Franceschi S, D’Avanzo B (1992) Reproductive factors and the risk of hepatocellular carcinoma in women. Int J Cancer 52:351–354PubMedGoogle Scholar
  23. 23.
    Wynder EL, Dodo H, Barber HR (1969) Epidemiology of cancer of the ovary. Cancer 23:352–370PubMedCrossRefGoogle Scholar
  24. 24.
    Tzonou A, Day NE, Trichopoulos D, et al. (1984) The epidemiology of ovarian cancer in Greece: a case–control study. Eur J Cancer Clin Oncol 20:1045–1052PubMedCrossRefGoogle Scholar
  25. 25.
    Kvale G, Heuch I, Nilssen S, Beral V (1988) Reproductive factors and risk of ovarian cancer: a prospective study. Int J Cancer 42:246–251PubMedGoogle Scholar
  26. 26.
    Harlow BL, Weiss NS, Roth GJ, Chu J, Daling JR (1988) Case–control study of borderline ovarian tumors: reproductive history and exposure to exogenous female hormones. Cancer Res 48:5849–5852PubMedGoogle Scholar
  27. 27.
    Hartge P, Schiffman MH, Hoover R (1989) A case–control study of epithelial ovarian cancer. Am J Obstet Gynecol 161:10–16PubMedGoogle Scholar
  28. 28.
    Polychronopoulou A, Tzonou A, Hsieh CC, et al. (1993) Reproductive variables, tobacco, ethanol, coffee and somatometry as risk factors for ovarian cancer. Int J Cancer 55:402–407PubMedGoogle Scholar
  29. 29.
    Risch HA, Marrett LD, Howe GR (1994) Parity, contraception, infertility, and the risk of epithelial ovarian cancer. Am J Epidemiol 140:585–597PubMedGoogle Scholar
  30. 30.
    Chen MT, Cook LS, Daling JR, Weiss NS (1996) Incomplete pregnancies and risk of ovarian cancer (Washington, United States). Cancer Causes Control 7:415–420PubMedCrossRefGoogle Scholar
  31. 31.
    Shu XO, Brinton LA, Gao YT, Yuan JM (1989) Population-based case–control study of ovarian cancer in Shanghai. Cancer Res 49:3670–3674PubMedGoogle Scholar
  32. 32.
    Titus-Ernstoff L, Perez K, Cramer DW, Harlow BL, Baron JA, Greenberg ER (2001) Menstrual and reproductive factors in relation to ovarian cancer risk. Br J Cancer 84:714–721PubMedCrossRefGoogle Scholar
  33. 33.
    Gierach GL, Modugno F, Ness RB (2005) Relations of gestational length and timing and type of incomplete pregnancy to ovarian cancer risk. Am J Epidemiol 161:452–461PubMedCrossRefGoogle Scholar
  34. 34.
    Mori M, Harabuchi I, Miyake H, Casagrande JT, Henderson BE, Ross RK (1998) Reproductive, genetic, and dietary risk factors for ovarian cancer. Am J Epidemiol 128:771–777Google Scholar
  35. 35.
    Negri E, Franceschi S, La Vecchia C, Parazzini F (1992) Incomplete pregnancies and ovarian cancer risk. Gynecol Oncol 47:234–238PubMedCrossRefGoogle Scholar
  36. 36.
    Greggi S, Parazzini F, Paratore MP, et al. (2000) Risk factors for ovarian cancer in central Italy. Gynecol Oncol 79:50–54PubMedCrossRefGoogle Scholar
  37. 37.
    Fernandez E, La Vecchia C, D’Avanzo B, Negri E (1995) Menstrual and reproductive factors and pancreatic cancer risk in women. Int J Cancer 62:11–14PubMedGoogle Scholar
  38. 38.
    Heuch I, Kvale G (2000) Menstrual and reproductive factors and risk of gastric cancer: a Norwegian cohort study. Cancer Causes Control 11:869–874PubMedCrossRefGoogle Scholar
  39. 39.
    La Vecchia C, D’Avanzo B, Franceschi S, Negri E, Parazzini F, Decarli A (1994) Menstrual and reproductive factors and gastric-cancer risk in women. Int J Cancer 59:761–764PubMedGoogle Scholar
  40. 40.
    Negri E, Dal Maso L, Ron E, et al. (1999) A pooled analysis of case–control studies of thyroid cancer. II. Menstrual and reproductive factors. Cancer Causes Control 10:143–155PubMedCrossRefGoogle Scholar
  41. 41.
    Sanderson M, Shu XO, Jin F, et al. (2003) Abortion history and breast cancer risk: results from the Shanghai breast cancer study. Int J Cancer 92:899–905CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Karin A. Rosenblatt
    • 1
  • Dao L. Gao
    • 2
  • Roberta M. Ray
    • 3
  • Michelle R. Rowland
    • 1
  • Zakia C. Nelson
    • 3
  • Karen J. Wernli
    • 3
    • 4
  • Wenjin Li
    • 3
  • David B. Thomas
    • 3
    • 4
  1. 1.Department of Kinesiology and Community HealthUniversity of Illinois at Urbana ChampaignChampaignUSA
  2. 2.Department of EpidemiologyZhong Shan Hospital Cancer CenterShanghaiPeople’s Republic of China
  3. 3.Program in EpidemiologyFred Hutchinson Cancer ResearchSeattleUSA
  4. 4.Department of EpidemiologyUniversity of WashingtonSeattleUSA

Personalised recommendations