A prospective study of induced abortion and breast cancer in African-American women

Abstract

Objective: There continues to be controversy about whether induced abortion influences the risk of breast cancer. Because case–control studies of this relation are subject to recall bias, there is a need for prospective data. Further, there has been little study of abortion and breast cancer in African-American women. We assessed the relation of abortion to risk of breast cancer in a prospective follow-up study of African-American women. Methods: Black Women's Health Study participants have been followed by mailed questionnaires every two years since enrollment in 1995. Participants reported 348 incident breast cancers during 205,983 person-years of follow-up. Women who had an induced abortion were compared with women who had never had one, with nulliparous and parous women analyzed separately. Incidence rate ratios (IRR) with two-sided 95% confidence intervals (CI) were derived from Cox regression models that controlled for age, age at first birth, number of births, history of spontaneous abortion, and other factors. Results: Among nulliparous women, the IRR for any induced abortion relative to none was 0.9 (95% CI = 0.5–1.4), and among parous women, the comparable IRR was 1.1 (95% CI = 0.8–1.4). Risk did not vary by number of abortions, age at first abortion, age at diagnosis or a family history of breast cancer in either nulliparous or parous women. Conclusions: Our findings indicate that induced abortion does not increase breast cancer risk in African-American women.

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References

  1. 1.

    Wingo PA, Newsome K,Marks JS,Calle EE, Parker SL (1997) The risk of breast cancer following spontaneous or induced abortion. Cancer Causes Control 8: 93-108.

    Google Scholar 

  2. 2.

    Pike MC, Henderson BE, Casagrande JT, Rosario I, Gray GE (1981) Oral contraceptive use and early abortion as risk factors for breast cancer in young women. Br J Cancer 43: 72-76.

    Google Scholar 

  3. 3.

    Brinton LA, Hoover R, Fraumeni JF Jr (1983) Reproductive factors in the aetiology of breast cancer. Br J Cancer 47: 757-762.

    Google Scholar 

  4. 4.

    Le M-G, Bachelot A, Doyon F, Kramar A, Hill C (1984) Oral contraceptive use and breast or cervical cancer: preliminary results of a French case-control study. In: Wol. J-P, Scott JS, eds. Hormones and Sexual Factors in Human Cancer Aetiology. New York: Elsevier, pp. 139-147.

    Google Scholar 

  5. 5.

    Rosenberg L, Palmer JR, Kaufman DW, Strom BL, Schottenfeld D, Shapiro S (1988) Breast cancer in relation to the occurence and time of induced and spontaneous abortion. Am J Epidemiol 127: 981-989.

    Google Scholar 

  6. 6.

    Ewertz M, Du.y SW (1988) Risk of breast cancer in relation to reproductive factors in Denmark. Br J Cancer 58: 99-104.

    Google Scholar 

  7. 7.

    Howe HL, Senie RT, Bzduch H, Herzfeld P (1989) Early abortion and breast cancer risk among women under age 40. Int J Epidemiol 18: 300-304.

    Google Scholar 

  8. 8.

    Lindefors-Harris B-M, Eklund G, Meirik O, Rutqvist LE, Wiklund K (1989) Risk of cancer of the breast after legal abortion during first trimester: a Swedish register study. BMJ 299: 1430-1432.

    Google Scholar 

  9. 9.

    Adami H-O, Bergstrom R, Lund E, Meirik O (1990) Absence of association between reproductive variables and the risk of breast cancer in young women in Sweden and Norway. Br J Cancer 62: 122-126.

    Google Scholar 

  10. 10.

    Bernstein L, Pike MC, Krailo M, Henderson BE (1990) Update of the Los Angeles study of oral contraceptives and breast cancer: 1981 and 1983. In: Mann RD, ed. Oral Contraceptives and Breast Cancer: The Implications of the Present Findings for Informed Consent and Informed Choice. Park Ridge, NJ: Parthenon Publishing Group, pp. 169-181.

    Google Scholar 

  11. 11.

    La Vecchia, Negri E, Franceschi S, Parazzini F (1993) Long-term impact of reproductive factors on cancer risk. Int J Cancer 53: 215-219.

    Google Scholar 

  12. 12.

    Laing AE, Demenais FM, Williams R, Kissling G, Chen VW, Bonney GE (1993) Breast cancer risk factors in African-American women: the Howard University Tumor Registry experience. J Natl Med Assoc 85: 931-939.

    Google Scholar 

  13. 13.

    Daling JR, Malone KE, Voigt LF, White E, Weiss NS (1994) Risk of breast cancer among young women: relationship to induced abortion. J Natl Cancer Inst 86: 1584-1592.

    Google Scholar 

  14. 14.

    Andrieu N, Clavel F, Gairard B, et al. (1994) Familial risk of breast cancer and abortion. Cancer Detect Prev 18: 51-55.

    Google Scholar 

  15. 15.

    Andrieu N, Du.y SW, Rohan TE, et al. (1995) Familial risk, abortion and their interactive effect on the risk of breast cancer-a combined analysis of 6 case-control studies. Br J Cancer 72: 744-751.

    Google Scholar 

  16. 16.

    Rookus MA and van Leeuwen FE (1996) Induced abortion and risk for breast cancer: reporting (recall) bias in a Dutch case-control study. J Natl Cancer Inst 88(23): 1759-1764.

    Google Scholar 

  17. 17.

    Lipworth L, Katsouyanni K, Ekbom A, Michels KB, Trichopoulos D (1995) Abortion and the risk of breast cancer: a case-control study in Greece. Int J Cancer 61: 181-184.

    Google Scholar 

  18. 18.

    Newcomb PA, Storer BE, Longnecker MP, Mittendorf R, Greenberg ER, Willett WC (1996) Pregnancy termination in relation to risk of breast cancer. JAMA 275: 283-287.

    Google Scholar 

  19. 19.

    Daling JR, Brinton LA, Voigt LF, et al. (1996) Risk of breast cancer among white women following induced abortion. Am J Epidemiol 144: 373-380.

    Google Scholar 

  20. 20.

    Melbye M, Wohlfahrt J, Olsen JH, et al. (1997) Induced abortion and the risk of breast cancer. N Engl J Med 336: 81-85.

    Google Scholar 

  21. 21.

    Palmer JR, Rosenberg L, Rao RS, et al. (1997) Induced and spontaneous abortion in relation to risk of breast cancer (United States). Cancer Causes Control 8: 841-849.

    Google Scholar 

  22. 22.

    Goldacre MJ, Kurina LM, Seagroatt V, Yeates D (2001) Abortion and breast cancer: a case-control record linkage study. J Epidemiol Community Health 55: 336-337.

    Google Scholar 

  23. 23.

    Newcomb PA and Mandelson MT (2000) A record-based evaluation of induced abortion and breast cancer risk (United States). Cancer Causes Control 11(9): 777-781.

    Google Scholar 

  24. 24.

    Lazovich D, Thompson JA, Mink PJ, Sellers TA, Anderson KE (2000) Induced abortion and breast cancer risk. Epidemiology 11: 76-80.

    Google Scholar 

  25. 25.

    Tang M-T, Weiss NS, Malone KE (2000) Induced abortion in relation to breast cancer among parous women: a birth certificate registry study. Epidemiology 11: 177-180.

    Google Scholar 

  26. 26.

    Sanderson M, Shu X-O, Jin F, et al. (2001) Abortion history and breast cancer risk: results from the Shanghai Breast Cancer Study. Int J Cancer 92: 899-905.

    Google Scholar 

  27. 27.

    Fioretti F, Tavani A, Bosetti C, et al. (1999) Risk factors for breast cancer in nulliparous women. Br J Cancer 79: 1923-1928.

    Google Scholar 

  28. 28.

    Marcus PM, Baird DD, Millikan RM, Moorman PG, Qaqish B, Newman B (1999) Adolescent reproductive events and subsequent breast cancer risk. Am J Public Health 89: 1244-1247.

    Google Scholar 

  29. 29.

    Erlandsson G, Montgomery SM, Cnattingius S, Ekbom A (2003) Abortions and breast cancer: record based case-control study. Int J Cancer 103: 676-679.

    Google Scholar 

  30. 30.

    Michels KB and Willett WC (1996) Does induced or spontaneous abortion affect the risk of breast cancer? Epidemiology 7: 521-528.

    Google Scholar 

  31. 31.

    Rosenberg L (1994) Induced abortion and breast cancer: more scientific data are needed (Editorial). JNCI 86: 1569-1570.

    Google Scholar 

  32. 32.

    Brind J, Chinchilli VM, Severs WB, Summy-Long J (1996) Induced abortion as an independent risk factor for breast cancer: a comprehensive review and meta-analysis. J Epidemiol Comm Health 50: 481-496.

    Google Scholar 

  33. 33.

    Brind J and Chinchilli VM (2002) Abortion and breast cancer. J Epidemiol Community Health 56(3): 237-238.

    Google Scholar 

  34. 34.

    Montana Abortion Control Act, Statutes (1995) Sections 50-20-104 and 50-20-106.

  35. 35.

    Mississippi Performance of Abortion Consent Statutes (1996) Section 41-41-33.

  36. 36.

    Rosenberg L, Adams-Campbell L, Palmer JR (1995) The Black Women's Health Study: a follow-up study for causes and prevention of illness. J Am Med Womens Assoc 50: 56-58.

    Google Scholar 

  37. 37.

    Cox DR (1972) Regression model and life tables (with discussion). JR Stat Soc (B) 34: 187-220.

    Google Scholar 

  38. 38.

    Russo J and Russo IH (1980) Susceptibility of the mammary gland to carcinogenesis. II. Pregnancy interruption as a risk factor in tumor incidence. Am J Pathol 100: 497-511.

    Google Scholar 

  39. 39.

    Henshaw SK (1998) Unintended pregnancy in the United States. Fam Plan Perspect 30: 24-29.

    Google Scholar 

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Correspondence to Julie R. Palmer.

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Palmer, J.R., Wise, L.A., Adams-Campbell, L.L. et al. A prospective study of induced abortion and breast cancer in African-American women. Cancer Causes Control 15, 105–111 (2004). https://doi.org/10.1023/B:CACO.0000019484.29558.f7

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  • abortion
  • African-American women
  • breast neoplasms
  • epidemiology