Abstract
There are known short-term benefits in breastfed infants versus bottle-fed infants in terms of lower risks of infection and obesity in infancy and childhood, but the long-term effect on the risk of adult cancers is unclear. In a cohort of 1 in 4 UK women born in 1935–1950 we report the incidence of adult cancers in relation to having been breastfed in infancy. In median year 2001 (interquartile range 2000–2003) 548,741 women without prior cancer reported whether they had been breastfed. There was 81% agreement between women’s report of having been breastfed and information on breastfeeding recorded when they were 2 years old. Participants were followed by record-linkage to national cancer registration, hospital admission and death databases. Cox regression yielded adjusted relative risks (RRs) and 95% confidence intervals (CI) by having been breastfed or not for eight cancer sites with > 2000 incident cases and for related conditions, where appropriate. Of the eight cancers examined here one association was highly statistically significant: an increase in colorectal cancer incidence among women who had been breastfed versus not (RR 1.18, 95% CI 1.12–1.24, n = 8651). To investigate further the findings for colorectal cancer, we studied eight other gastro-intestinal conditions, and found increased risks in women who had been breastfed versus not for benign colorectal polyps (RR 1.09, 95% CI 1.05–1.13, n = 17,677) and for appendicitis (RR 1.19, 95% CI 1.07–1.31, n = 2108). The greater risks of adult colorectal cancer, colorectal polyps and appendicitis associated with having been breastfed in infancy suggest possible long-term effects of infant feeding practices on the gastrointestinal tract. Further studies are required to clarify this novel association.
Highlights
There are known short-term benefits in breastfed infants versus bottle-fed infants in terms of lower risks of infection and obesity in infancy and childhood [1], and some evidence has suggested a reduced long-term risk of obesity and diabetes in adulthood [2]
After stratification by single year of birth and single year at baseline and adjustment for 14 additional factors, women who had been breastfed had a significantly higher risk of colorectal cancer (8651 incident cases, adjusted relative risks (RRs) 1.18, 95% confidence intervals (CI) 1.12–1.24, p < 0.0000001; Fig. 1), but for the other 7 cancer sites there was no difference in risk by whether or not women had been breastfed (p > 0.05)
For breast cancer there was no association overall (25,665 cases, RR 1.01, 95% CI 0.99–1.04) or when analyses were restricted to women whose mother had had breast cancer (2876 cases, RR 0.96, 95% CI 0.88–1.04)
Summary
There are known short-term benefits in breastfed infants versus bottle-fed infants in terms of lower risks of infection and obesity in infancy and childhood [1], and some evidence has suggested a reduced long-term risk of obesity and diabetes in adulthood [2]. Evidence on the long-term effects on other aspects of adult health, and on the risk of adult cancer, is limited. Of eight common adult cancers in those who reported that they were and were not breastfed as infants
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