Abstract

BackgroundEarly age at menarche, late age at menopause, and late age at first full-term pregnancy are linked to a modest increase in the risk of developing breast cancer (breast ca). This study aims to investigate the reproductive determinants of breast cancer among women in the West Bank of Palestine.A structured questionnaire was used to collect data in a case-control study (237 registered cases and 237 controls). A multivariate analysis model was used to adjust for the association between women’s reproductive factors and breast ca risk. This study was approved by Al Quds University Ethical Research Committee and the Ministry of Health research unit. ResultsIn the multivariate analysis, menarche after 13 years of age, use of oral contraceptives for more than two months, and hormonal contraceptives use significantly doubled the risk for breast ca (Adjusted Odds Ratio (AOR) = 2.03, 95 % CI: 1.21–4.37, p < 0.011 and AOR = 2.2, 95 % CI: 1.24–4.01, p = 0.008, respectively). Women who used hormone replacement therapy (HRT) were significantly associated with higher odds (5 folds) of having breast ca versus those who did not use them (AOR 5.02, 95 % CI: 1.93–13.06, p = 0.001). Similarly, nulliparous women showed 6 times the odds of breast ca compared with women with one or more children (p = 0.005). Also, parental consanguinity marriage (AOR 2.59, 95 % CI: 1.53–4.36, p = 0.001) and positive family history (AOR 3.88, 95 % CI: 2.19–6.87, p = 0.001) of the condition can be strong determinants for breast ca in this study. ConclusionThis study provides clear evidence that the use of reproductive hormones, whether as a birth control tool or for therapeutic purposes, must be rationalized worldwide and in Palestine in particular.

Highlights

  • Breast cancer is the most common form of cancer mortality among women in the world[1].Breast cancer is a multi-factorial type of cancer

  • Regarding the use of hormonal contraceptive pills (OCP) and their association with breast ca, our study showed that previous oral OCP use for more than two months significantly doubled the risk of breast ca (AOR=2.22), but failed to show any link to the duration of using OCP

  • Significant differences in breast ca were found between the study cases and control group: age at puberty, use of OCP and hormone replacement therapy (HRT), nullparity, early marriage, early pregnancy, and early delivery

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Summary

Introduction

Breast cancer (breast ca) is the most common form of cancer mortality among women in the world[1].Breast cancer is a multi-factorial type of cancer. Among women aged 40 years or more, breast ca is related to increased risk 6,7. Modifiable risk factors such as obesity, physical inactivity, sedentary behavior, and poor dietary patterns were shown to be related to breast cancer risk 8-10. Late age at menopause, and late age at first full-term pregnancy are linked to a modest increase in the risk of developing breast cancer 14,15. Late age at menopause, and late age at first full-term pregnancy are linked to a modest increase in the risk of developing breast cancer (breast ca). This study aims to investigate the reproductive determinants of breast cancer among women in the West Bank of Palestine. This study was approved by Al Quds University Ethical Research Committee and the Ministry of Health research unit

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