Reproductive history and breast cancer survival: Findings from the African breast cancer-Disparities in outcomes cohort and implications of Africa's fertility transition on breast cancer prognosis.

Autor: Boucheron P; International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France., Anele A; FMC, Owerri, Nigeria., Offiah AU; Abia State University Teaching Hospital, Aba, Nigeria., Zietsman A; AB May Cancer Centre, Windhoek Central Hospital, Windhoek, Namibia., Galukande M; College of Health Sciences, Makerere University, Kampala, Uganda., Parham G; Department of Obstetrics and Gynaecology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA., Pinder LF; University of Washington, Seattle, Washington, USA., Anderson BO; University of Washington, Seattle, Washington, USA.; World Health Organization, Geneva, Switzerland., Foerster M; International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France., Schüz J; International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France., Dos-Santos-Silva I; Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, UK., McCormack V; International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2023 May 01; Vol. 152 (9), pp. 1804-1816. Date of Electronic Publication: 2023 Jan 03.
DOI: 10.1002/ijc.34411
Abstrakt: Reproductive characteristics are known risk factors for breast cancer but, other than recent birth, their role as prognostic factors is less clear, and has not been studied in Sub-Saharan Africa (SSA). In this setting, we examined whether reproductive factors independently influence breast cancer survival in a subset of the African Breast Cancer-Disparities in Outcomes cohort study. In 1485 women with incident breast cancer recruited between 2014 and 2017, we examined birth cohort changes in reproductive factors, and used Cox models to examine whether reproductive characteristics were associated with all-cause mortality after adjusting for confounders (age, stage, treatment, HIV, and social factors). Four years after diagnosis, 822 (56%) women had died. Median parity was 4 (IQR = 2, 6) and 209 (28%) of premenopausal women had had a recent birth (<3 years prior to cancer diagnosis). Each pregnancy was associated with a 5% increase (95% CI: 2%, 8%) in mortality rates, which held among postmenopausal women (5%, [1%-9%]). Pre-menopausal women with a recent birth had 52% (20%, 92%) higher mortality rates. Fertility trends by birth cohort showed declining parity, increasing age at first birth and declining age at last birth, however the impact of these population-level changes on future average survival was predicted to be very small (<3% absolute gain).
(© 2022 The World Health Organization. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.)
Databáze: MEDLINE
Externí odkaz: