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Reproductive factors and the risk of breast cancer among Nigerian women by age and oestrogen receptor status

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Abstract

Purpose of the study

The aim of the study was to investigate the association between reproductive factors and breast cancer risk in Nigeria. This has not been widely investigated in sub-Saharan Africa.

Methods

We conducted a hospital-based case–control study involving participants from five hospitals in Lagos and Abuja. Women were interviewed in-person between October 2016 and May 2017 using a semi-structured questionnaire. We collected data on parity, breastfeeding, age at first and last birth, age at menarche, oral contraceptive use and history of abortion. The data were analysed using multivariable logistic regression adjusting for relevant confounders.

Results

Every additional 6 months of breastfeeding over a lifetime reduced breast cancer odds by: 7% (95% CI: 1%, 12%) in all women, 15% (95% CI: 5%, 24%) in women < 50 years, and 8% (95% CI: 0%, 12%, p for trend = 0.043) in oestrogen receptor negative (ER-) cases. Each additional 1-year delay before the first full-term pregnancy increased oestrogen receptor positive breast cancer odds by 9% (95% CI: 2%, 17%). Each additional 1-year delay before the last full-term pregnancy increased breast cancer odds by: 7% (95% CI: 2%, 12%) in all women, 12% (95% CI: 4%, 21%) in ER- breast cancer patients, and 14% (95% CI: 4%, 25%) in triple negative breast cancer patients. Other reproductive factors did not significantly increased breast cancer odds.

Conclusion

While advanced age at first and last full-term pregnancies increased breast cancer odds, breastfeeding reduced it. These associations varied by age and oestrogen receptor status. Improved breastfeeding practices and timely births should be promoted in Nigeria.

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Data availability

The data generated and analysed during the current study are not publicly available because other related contents of the data sets are still being analysed for possible publications but are subsequently available from the corresponding author on reasonable request.

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Acknowledgments

We hereby appreciate the Vice Chancellor and Management of the National Open University of Nigeria for their financial support towards the execution of this study. We thank the members of the various Ethics Committees and clinicians in the participating hospitals as well as nurses and medical record officers. The dedication shown by our trained interviewers especially Eberechukwu, Onyinyechi, Rejoice, Gloria, Echezona, Samuel and Made are hereby appreciated. We owe our deepest gratitude to all the study participants especially the breast cancer patients, some of whom provided information amidst discomforts. Their courage and confidence in the usefulness of this study are very much appreciated.

Funding

The study was partially funded by National Open University of Nigeria, Plot 91, Cadastral Zone, Nnamdi Azikiwe Express Way, Jabi, Abuja, Nigeria.

Author information

Authors and Affiliations

  1. Department of Public Health, National Open University of Nigeria, Plot 91, Cadastral Zone, Nnamdi Azikiwe Express Way, Jabi, Abuja, Nigeria

    Samuel O. Azubuike

  2. Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, England

    Samuel O. Azubuike, Louise Hayes, Linda Sharp & Richard McNally

Authors
  1. Samuel O. Azubuike
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  2. Louise Hayes
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  4. Richard McNally
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Contributions

SO conceived the study, contributed to study design, data acquisition, analysis, interpretation of results, preparation of the first draft, subsequent revision and final report.RM and LH contributed in the study design, data acquisition, analysis, interpretation, revision of the draft, and final report. LS contributed to the study design, data analysis, interpretation, revision of the draft paper, and the final report. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Samuel O. Azubuike.

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Competing interest

The authors declare that they have no conflicts of interests.

Ethical approval

The study protocol and data collection instruments were approved by the Ethics Committees of the five participating hospitals (NHA/EC/085/2016; FCT/UATH/HREC/PR/537; ADM/DCST/HREC/APP/1108; NRECC04/04/2008; SUB/GHL/1288/19) described earlier as well as those of Newcastle University, United Kingdom (1031/2016) and Lagos State Health Services Commission, Lagos, Nigeria (LSHSC/2222/Vol. XIX/48).

Informed consent

Informed consent was obtained in writing from all participants using a consent form specifically prepared for the purpose. In the case of the aged and illiterate participants, it was obtained by proxy through a relative they trusted and designed to act on their behalf. The study was performed per the Declaration of Helsinki.

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Azubuike, S.O., Hayes, L., Sharp, L. et al. Reproductive factors and the risk of breast cancer among Nigerian women by age and oestrogen receptor status. Cancer Causes Control 33, 1401–1412 (2022). https://doi.org/10.1007/s10552-022-01629-z

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  • DOI: https://doi.org/10.1007/s10552-022-01629-z

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