Cancer Causes & Control

, Volume 21, Issue 1, pp 109–116 | Cite as

Breastfeeding and risk of epithelial ovarian cancer

  • Susan J. Jordan
  • Victor Siskind
  • Adèle C Green
  • David C. Whiteman
  • Penelope M. Webb
Original paper

Abstract

Objective

Several studies have found inverse associations between breastfeeding and ovarian cancer occurrence but there are inconsistencies. The relationship with breastfeeding duration is unclear, and it is uncertain whether the association varies according to histological subtype of ovarian cancer. We sought to clarify these issues.

Methods

Parous women who participated in an Australia-wide population-based case–control study of epithelial ovarian cancer between 2001 and 2005 (1,092 cases and 1,288 controls) completed a reproductive/lifestyle questionnaire. Logistic regression was used to calculate odds ratios and 95% confidence intervals to investigate relations between breastfeeding and ovarian cancer.

Results

We found a strong inverse association between total duration of breastfeeding (all episodes combined) and ovarian cancer occurrence (OR = 0.986, 95% CI 0.978–0.994 per month of breastfeeding) that appeared to be independent of parity. However, individual episodes of lactation beyond 12 months conferred no appreciable additional benefit. The relation with breastfeeding appeared to vary by histological subtype such that we saw no association between duration of breastfeeding and borderline serous cancers or mucinous cancers, but inverse associations for the other subtypes, although these were not always statistically significant.

Conclusions

A long total duration of breastfeeding appears to be associated with a substantial reduction in the overall risk of ovarian cancer, independent of the decrease in risk due to childbirth, but this may vary according to histological subtype.

Keywords

Ovarian cancer Risk factors Breastfeeding 

References

  1. 1.
    Fathalla MF (1971) Incessant ovulation—a factor in ovarian neoplasia? Lancet 2(7716):163CrossRefPubMedGoogle Scholar
  2. 2.
    Cramer D, Welch WR (1983) Determinants of ovarian cancer risk. II. Inferences regarding pathogenesis. J Natl Cancer Inst 71(4):717–721PubMedGoogle Scholar
  3. 3.
    McNeilly AS (2001) Lactational control of reproduction. Reprod Fertil Dev 13(7–8):583–590CrossRefPubMedGoogle Scholar
  4. 4.
    Danforth KN et al. (2007) Breastfeeding and risk of ovarian cancer in two prospective cohorts. Cancer Causes Control 18(5):517–523Google Scholar
  5. 5.
    Riman S, Nilsson T, Persson IR (2004) Review of epidemiological evidence for reproductive and hormonal factors in relation to the risk of epithelial ovarian malignancies. Acta Obstet Gynecol Scand 83(9):783–795PubMedGoogle Scholar
  6. 6.
    World Cancer Research Fund/American Institue for Cancer Research (2007) Food, nutrition physical activity and the prevention of cancer: a global perspective. AICR, Washington DCGoogle Scholar
  7. 7.
    Chiaffarino F et al (2005) Breastfeeding and the risk of epithelial ovarian cancer in an Italian population. Gynecol Oncol 98(2):304–308CrossRefPubMedGoogle Scholar
  8. 8.
    Modugno F, Ness RB, Wheeler J (2001) Reproductive risk factors for epithelial ovarian cancer according to histological type and invasiveness. Ann Epidemiol 11:568–574CrossRefPubMedGoogle Scholar
  9. 9.
    Titus-Ernstoff L et al (2001) Menstrual and reproductive factors in relation to ovarian cancer risk. Br J Cancer 84(5):714–721CrossRefPubMedGoogle Scholar
  10. 10.
    Risch H et al (1996) Differences in risk factors for epithelial ovarian cancer by histologic type. Results of a case–control study. Am J Epidemiol 144(4):363–372PubMedGoogle Scholar
  11. 11.
    Riman T et al (2002) Risk factors for invasive epithelial ovarian cancer: results from a Swedish case–control study. Am J Epidemiol 156(4):363–373CrossRefPubMedGoogle Scholar
  12. 12.
    Tung KH et al (2003) Reproductive factors and epithelial ovarian cancer risk by histologic type: a multiethnic case–control study. Am J Epidemiol 158(7):629–638CrossRefPubMedGoogle Scholar
  13. 13.
    Mills PK, Riordan DG, Cress RD (2004) Epithelial ovarian cancer risk by invasiveness and cell type in the Central Valley of California. Gynecol Oncol 95(1):215–225CrossRefPubMedGoogle Scholar
  14. 14.
    Kurian AW et al (2005) Histologic types of epithelial ovarian cancer: have they different risk factors? Gynecol Oncol 96(2):520–530CrossRefPubMedGoogle Scholar
  15. 15.
    Short RV et al (1991) Contraceptive effects of extended lactational amenorrhoea: beyond the Bellagio Consensus. Lancet 337(8743):715–717CrossRefPubMedGoogle Scholar
  16. 16.
    Merritt MA et al (2008) Talcum powder, chronic pelvic inflammation and NSAIDs in relation to risk of epithelial ovarian cancer. Int J Cancer 122(1):170–176CrossRefPubMedGoogle Scholar
  17. 17.
    Olsen CM et al (2007) Recreational physical activity and epithelial ovarian cancer: a case–control study, systematic review, and meta-analysis. Cancer Epidemiol Biomarkers Prev 16(11):2321–2330CrossRefPubMedGoogle Scholar
  18. 18.
    Jordan SJ et al (2008) Serous ovarian, fallopian tube and primary peritoneal cancers: a comparative epidemiological analysis. Int J Cancer 122(7):1598–1603CrossRefPubMedGoogle Scholar
  19. 19.
    Bell DA (2005) Origins and molecular pathology of ovarian cancer. Mod Pathol 18(Suppl 2):S19–S32CrossRefPubMedGoogle Scholar
  20. 20.
    Siskind V et al (1997) Breastfeeding, menopause, and epithelial ovarian cancer. Epidemiol 8(2):188–191CrossRefGoogle Scholar
  21. 21.
    Whittemore AS, Harris R, Itnyre J (1992) Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case–control studies. II. Invasive epithelial ovarian cancers in white women collaborative ovarian cancer group. Am J Epidemiol 136(10):1184–1203PubMedGoogle Scholar
  22. 22.
    Booth M, Beral V, Smith P (1989) Risk factors for ovarian cancer: a case–control study. Br J Cancer 60(4):592–598PubMedGoogle Scholar
  23. 23.
    ABS. Australian Bureau of Statistics. National Health Survey: Users’ Guide, 2001 http://abs.gov.au/Ausstats/abs@.nsf/ accessed 24th July 2006. 2001 [cited 2006 24-07-06]; Available from: http://abs.gov.au/Ausstats/abs@.nsf/
  24. 24.
    Purdie D et al (2003) The different etiologies of mucinous and non-mucinous epithelial ovarian cancers. Gynecol Oncol 14(1 Pt 2):5–148Google Scholar
  25. 25.
    Jordan SJ et al (2007) Risk factors for benign, borderline and invasive mucinous ovarian tumors: epidemiological evidence of a neoplastic continuum? Gynecol Oncol 107(2):223–230CrossRefPubMedGoogle Scholar
  26. 26.
    Jordan S, Green A, Webb P (2006) Benign epithelial ovarian tumours-cancer precursors or markers for ovarian cancer risk? Cancer Causes Control 17(5):623–632CrossRefPubMedGoogle Scholar
  27. 27.
    Tung KH et al (2005) Effect of anovulation factors on pre- and postmenopausal ovarian cancer risk: revisiting the incessant ovulation hypothesis. Am J Epidemiol 161(4):321–329CrossRefPubMedGoogle Scholar
  28. 28.
    Cramer D, Xu H (1995) Epidemiologic evidence for uterine growth factors in the pathogenesis of ovarian cancer. Ann Epidemiol 5(4):310–314CrossRefPubMedGoogle Scholar
  29. 29.
    Green A et al (1997) Tubal sterilisation, hysterectomy, and decreased risk of ovarian cancer. Int J Cancer 71:948–951CrossRefPubMedGoogle Scholar
  30. 30.
    Ness RB, Cottreau C (1999) Possible role of ovarian epithelial inflammation in ovarian cancer. J Natl Cancer Inst 91(17):1459–1467CrossRefPubMedGoogle Scholar
  31. 31.
    Risch H (1998) Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone. J Natl Cancer Inst 90(23):1774–1786CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Susan J. Jordan
    • 1
    • 2
  • Victor Siskind
    • 2
  • Adèle C Green
    • 2
  • David C. Whiteman
    • 2
  • Penelope M. Webb
    • 2
  1. 1. School of Population HealthThe University of QueenslandHerston, BrisbaneAustralia
  2. 2.Genetics and Population Health DivisionThe Queensland Institute of Medical ResearchBrisbaneAustralia

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