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Association between abortion and breast cancer: an updated systematic review and meta-analysis based on prospective studies

Abstract

Objective

Although positive association between abortion and breast cancer was frequently reported from case–control studies, results from prospective studies were still unclear. This study aimed to evaluate this association based on prospective studies.

Methods

PubMed, ISI Web of Knowledge and Embase were systematically searched for prospective studies on the association between abortion and breast cancer up to April 2014, supplemented by manual searches on the references. Two reviewers independently conducted the literature search, study selection, data extraction, and quality assessment of included studies. Random effects models were used to estimate the combined relative risks (RRs) and corresponding 95 % confidence intervals (95 % CIs).

Results

Fifteen prospective studies [14 focused on induced abortion (IA), and 12 focused on spontaneous abortion (SA)] were included in the final analysis. The combined RRs (95 % CIs) of breast cancer risk were 1.00 (0.94–1.05) [1.00 (0.92–1.08) for cumulative-incidence data and 1.00 (0.94–1.05) for incidence-rate data] for IA, and 1.02 (0.95–1.09) [1.06 (0.96–1.16) for cumulative-incidence data and 1.01 (0.92–1.09) for incidence-rate data] for SA, respectively. Non-significant associations of breast cancer with IA and SA were also found among nulliparous women, women with abortion before or after the first full-term pregnancy, women with one or ≥2 abortions, and women with first abortion after 30 years old.

Conclusion

The current prospective evidences are not sufficient to support the positive association between abortion (including IA and SA) and breast cancer risk.

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Authors

Corresponding author

Correspondence to Wengang Qin.

Additional information

Jun Guo and Yubei Huang contributed equally to the first author.

Electronic supplementary material

Below is the link to the electronic supplementary material.

10552_2015_536_MOESM1_ESM.pptx

Supplement Fig. 1. Sensitivity analysis of association of induced abortion with breast cancer risk after excluding the study with largest weight. Each row in the forest graph represents the original relative risk (RR) with 95 % confidence intervals (CIs) reported in each study. And the last row represents the overall RR (95 % CI). Palmer (2004a) and Palmer (2004b) [Henderson (2008a) and Henderson (2008b)] represented the datasets for nulliparous women and parous women, respectively. (PPTX 52 kb)

10552_2015_536_MOESM2_ESM.pptx

Supplement Fig. 2. Sensitivity analysis of association of spontaneous abortion with breast cancer risk after excluding the study with largest weight. Each row in the forest graph represents the original relative risk (RR) with 95 % confidence intervals (CIs) reported in each study. And the last row represents the overall RR (95 % CI). Hadjimichael (1986a) and Hadjimichael (1986b) represented the datasets for women with one parity and women with two and more parity, respectively. And Henderson (2008a) and Henderson (2008b) represented the datasets for nulliparous women and parous women, respectively. (PPTX 52 kb)

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Guo, J., Huang, Y., Yang, L. et al. Association between abortion and breast cancer: an updated systematic review and meta-analysis based on prospective studies. Cancer Causes Control 26, 811–819 (2015). https://doi.org/10.1007/s10552-015-0536-1

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  • DOI: https://doi.org/10.1007/s10552-015-0536-1

Keywords

  • Induced abortion
  • Spontaneous abortion
  • Breast cancer
  • Prospective study
  • Systematic review
  • Meta-analysis