Breast cancer risk factors in Iran: A systematic review & Meta-analysis

Shamshirian, A. and Heydari, K. and Shams, Z. and Aref, A.R. and Shamshirian, D. and Tamtaji, O.R. and Asemi, Z. and Shojaie, L. and Mirzaei, H. and Mohammadi, N. and Zibaee, B. and Karimifar, K. and Zarandi, B. and Hedayatizadeh-Omran, A. and Alizadeh-Navaei, R. (2020) Breast cancer risk factors in Iran: A systematic review & Meta-analysis. Hormone Molecular Biology and Clinical Investigation, 41 (4).

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Abstract

Objectives: Breast cancer is known as one of the deadliest forms of cancer, and it is increasing globally. There are a variety of proven and controversial risk factors for this malignancy. Herein, we aimed to undertake a systematic review and meta-analysis focus on the epidemiology of breast cancer risk factors in Iran. Methods: We performed a systematic search via PubMed, Scopus, Web of Science, and Persian databases for identifying studies published on breast cancer risk factors up to March 2019. Meta-analyses were done for risk factors reported in more than one study. We calculated odds ratios (ORs) with corresponding 95 confidence intervals (CIs) using a fixed/random-effects models. Results: Thirty-nine studies entered into the meta-analysis. Pooling of ORs showed a significant harmful effect for risk factors including family history (OR: 1.80, 95CI 1.47-2.12), hormonal replacement therapy (HRT) (OR: 5.48, 95CI 0.84-1.74), passive smokers (OR: 1.68, 95CI 1.34-2.03), full-term pregnancy at age 30 (OR: 3.41, 95CI 1.19-5.63), abortion (OR: 1.84, 95CI 1.35-2.33), sweets consumption (OR: 1.71, 95CI 1.32-2.11) and genotype Arg/Arg (crude OR: 1.59, 95CI 1.07-2.10), whereas a significant protective effect for late menarche (OR: 0.58, 95CI 0.32-0.83), nulliparity (OR: 0.68, 95CI 0.39-0.96), 13-24 months of breastfeeding (OR: 0.68, 95CI 0.46-0.90), daily exercise (OR: 0.59, 95CI 0.44-0.73) and vegetable consumption (crude OR: 0.28, 95CI 0.10-0.46). Conclusions: This study suggests that factors such as family history, HRT, passive smokers, late full-term pregnancy, abortion, sweets consumption and genotype Arg/Arg might increase risk of breast cancer development, whereas late menarche, nulliparity, 13-24 months breastfeeding, daily exercise and vegetable consumption had an inverse association with breast cancer development. © 2020 Amir Shamshirian et al., published by De Gruyter.

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