背景:确定乳腺癌的危险因素是该疾病预防策略的关键组成部分。这项研究旨在确定伊朗女性乳腺癌的可改变和不可改变的危险因素。
方法:我们使用了国际数据库(PubMed/Medline,Scopus,WebofKnowledge,和Embase)和国家数据库(SID,马吉兰,和ISC)检索相关研究,直到2022年11月13日。使用随机效应模型以95%置信区间的比值比(OR)来估计合并效应。发表偏倚通过Egger和Begg检验进行评估。进行敏感性分析以评估每个纳入研究对最终测量的影响。
结果:在检索到的30,351篇文章中,24个匹配的病例对照记录包括12,460名参与者(5675例新诊断的乳腺癌病例和6785例对照)。这项荟萃分析显示,在已知的乳腺癌可改变的危险因素中,肥胖(与正常体重相比)的风险最高(OR=2.17,95%CI1.47至3.21;I2=85.7),其次是结婚年龄(25-29vs<18岁)(OR=2.00,95%CI1.53至2.61;I2=0),二手烟(OR=1.86,95%CI1.58至2.19;I2=0),吸烟(OR=1.83,95%CI1.41至2.38;I2=18.9),流产史(OR=1.44,95%CI1.02至2.05;I2=66.3),口服避孕药使用(OR=1.35,95%CI1.11至1.63;I2=74.1),结婚年龄(18-24岁vs<18岁)(OR:1.22,95%CI1.02至1.47;I2=0)。在不可改变的风险因素中,辐射暴露史(OR=3.48,95%CI2.17至5.59;I2=0),乳腺癌家族史(OR=2.47,95%CI1.83至3.33;I2=73),初潮年龄(12-13岁vs≥14岁)(OR=1.67,95%CI1.31-2.13;I2=25.4)显着增加了患乳腺癌的风险。
结论:由于大多数与乳腺癌发病率相关的危险因素是可以改变的,促进健康的生活方式可以在预防乳腺癌方面发挥重要作用。初潮年龄较小的女性,有乳腺癌家族史,或者辐射暴露史,建议在短时间内进行筛查。
BACKGROUND: Identifying breast cancer risk factors is a critical component of preventative strategies for this disease. This study aims to identify modifiable and non-modifiable risk factors of breast cancer in Iranian women.
METHODS: We used international databases (PubMed/Medline, Scopus, Web of Knowledge, and Embase) and national databases (SID, Magiran, and ISC) to retrieve relevant studies until November 13, 2022. The odds ratio (OR) with a 95% confidence interval using the random-effect model was used to estimate the pooled effect. The publication bias was assessed by the Egger and Begg test. A sensitivity analysis was conducted to evaluate the effect of each included study on the final measurement.
RESULTS: Of the 30,351 retrieved articles, 24 matched case-control records were included with 12,460 participants (5675 newly diagnosed cases of breast cancer and 6785 control). This meta-analysis showed that of the known modifiable risk factors for breast cancer, obesity (vs normal weight) had the highest risk (OR = 2.17, 95% CI 1.47 to 3.21; I2 = 85.7) followed by age at marriage (25-29 vs < 18 years old) (OR = 2.00, 95% CI 1.53 to 2.61; I2 = 0), second-hand smoking (OR = 1.86, 95% CI 1.58 to 2.19; I2 = 0), smoking (OR = 1.83, 95% CI 1.41 to 2.38; I2 = 18.9), abortion history (OR = 1.44, 95% CI 1.02 to 2.05; I2 = 66.3), oral contraceptive use (OR = 1.35, 95% CI 1.11 to 1.63; I2 = 74.1), age at marriage (18-24 vs < 18 years old) (OR: 1.22, 95% CI 1.02 to 1.47; I2 = 0). Of non-modifiable risk factors, history of radiation exposure (OR = 3.48, 95% CI 2.17 to 5.59; I2 = 0), family history of breast cancer (OR = 2.47, 95% CI 1.83 to 3.33; I2 = 73), and age at menarche (12-13 vs ≥ 14 years old) (OR = 1.67, 95% CI 1.31-2.13; I2 = 25.4) significantly increased the risk of breast cancer.
CONCLUSIONS: Since most risk factors related to breast cancer incidence are modifiable, promoting healthy lifestyles can play an influential role in preventing breast cancer. In women with younger menarche age, a family history of breast cancer, or a history of radiation exposure, screening at short intervals is recommended.