Susan J Jordan1, Renhua Na, Sharon E Johnatty, Lauren A Wise, Hans Olov Adami, Louise A Brinton, Chu Chen, Linda S Cook, Luigino Dal Maso, Immaculata De Vivo, Jo L Freudenheim, Christine M Friedenreich, Carlo La Vecchia, Susan E McCann, Kirsten B Moysich, Lingeng Lu, Sara H Olson, Julie R Palmer, Stacey Petruzella, Malcolm C Pike, Timothy R Rebbeck, Fulvio Ricceri, Harvey A Risch, Carlotta Sacerdote, Veronica Wendy Setiawan, Todd R Sponholtz, Xiao Ou Shu, Amanda B Spurdle, Elisabete Weiderpass, Nicolas Wentzensen, Hannah P Yang, Herbert Yu, Penelope M Webb. 1. QIMR Berghofer Medical Research Institute, and the University of Queensland, School of Public Health, Brisbane, Australia; the Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland; the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; the Department of Internal Medicine and UNM Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico; the Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada; the Unit of Cancer Epidemiology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; the Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York; the Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy; Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York; Yale School of Public Health, New Haven, Connecticut; the Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York; Slone Epidemiology Center, Boston University, Boston, Massachusetts; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Harvard TH Chan School of Public Health and Dana Farber Cancer Institute, Boston, Massachusetts; the Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy; the Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Centre, Vanderbilt University School of Medicine, Nashville, Tennessee; the Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; the Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland; the Department of Community Medicine, University of Tromsø, and the Arctic University of Norway, Tromsø, Norway; and the Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
Abstract
OBJECTIVE: To investigate the association between breastfeeding and endometrial cancer risk using pooled data from 17 studies participating in the Epidemiology of Endometrial Cancer Consortium. METHODS: We conducted a meta-analysis with individual-level data from three cohort and 14 case-control studies. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the association between breastfeeding and risk of endometrial cancer using multivariable logistic regression and pooled using random-effects meta-analysis. We investigated between-study heterogeneity with I and Q statistics and metaregression. RESULTS: After excluding nulliparous women, the analyses included 8,981 women with endometrial cancer and 17,241 women in a control group. Ever breastfeeding was associated with an 11% reduction in risk of endometrial cancer (pooled OR 0.89, 95% CI 0.81-0.98). Longer average duration of breastfeeding per child was associated with lower risk of endometrial cancer, although there appeared to be some leveling of this effect beyond 6-9 months. The association with ever breastfeeding was not explained by greater parity and did not vary notably by body mass index or histologic subtype (grouped as endometrioid and mucinous compared with serous and clear cell). CONCLUSION: Our findings suggest that reducing endometrial cancer risk can be added to the list of maternal benefits associated with breastfeeding. Ongoing promotion, support, and facilitation of this safe and beneficial behavior might therefore contribute to the prevention of this increasingly common cancer.
OBJECTIVE: To investigate the association between breastfeeding and endometrial cancer risk using pooled data from 17 studies participating in the Epidemiology of Endometrial Cancer Consortium. METHODS: We conducted a meta-analysis with individual-level data from three cohort and 14 case-control studies. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the association between breastfeeding and risk of endometrial cancer using multivariable logistic regression and pooled using random-effects meta-analysis. We investigated between-study heterogeneity with I and Q statistics and metaregression. RESULTS: After excluding nulliparous women, the analyses included 8,981 women with endometrial cancer and 17,241 women in a control group. Ever breastfeeding was associated with an 11% reduction in risk of endometrial cancer (pooled OR 0.89, 95% CI 0.81-0.98). Longer average duration of breastfeeding per child was associated with lower risk of endometrial cancer, although there appeared to be some leveling of this effect beyond 6-9 months. The association with ever breastfeeding was not explained by greater parity and did not vary notably by body mass index or histologic subtype (grouped as endometrioid and mucinous compared with serous and clear cell). CONCLUSION: Our findings suggest that reducing endometrial cancer risk can be added to the list of maternal benefits associated with breastfeeding. Ongoing promotion, support, and facilitation of this safe and beneficial behavior might therefore contribute to the prevention of this increasingly common cancer.
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