Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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The Effect of Breastfeeding Duration and Parity on the Risk of Epithelial Ovarian Cancer: A Systematic Review and Meta-analysis

  • Sung, Ho Kyung (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Ma, Seung Hyun (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Choi, Ji-Yeob (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Hwang, Yunji (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Ahn, Choonghyun (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Kim, Byoung-Gie (Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Yong-Man (Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jae Weon (Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kang, Sokbom (Department of Gynecologic Oncology, National Cancer Center) ;
  • Kim, Jaehoon (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Tae Jin (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Yoo, Keun-Young (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Kang, Daehee (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Park, Suekyung (Department of Preventive Medicine, Seoul National University College of Medicine)
  • Received : 2016.06.29
  • Accepted : 2016.09.08
  • Published : 2016.11.30
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Abstract

Objectives: We conducted a systematic review and meta-analysis to summarize current evidence regarding the association of parity and duration of breastfeeding with the risk of epithelial ovarian cancer (EOC). Methods: A systematic search of relevant studies published by December 31, 2015 was performed in PubMed and EMBASE. A random-effect model was used to obtain the summary relative risks (RRs) and 95% confidence intervals (CIs). Results: Thirty-two studies had parity categories of 1, 2, and ${\geq}3$. The summary RRs for EOC were 0.72 (95% CI, 0.65 to 0.79), 0.57 (95% CI, 0.49 to 0.65), and 0.46 (95% CI, 0.41 to 0.52), respectively. Small to moderate heterogeneity was observed for one birth (p<0.01; Q = 59.46; $I^2=47.9%$). Fifteen studies had breastfeeding categories of <6 months, 6-12 months, and >13 months. The summary RRs were 0.79 (95% CI, 0.72 to 0.87), 0.72 (95% CI, 0.64 to 0.81), and 0.67 (95% CI, 0.56 to 0.79), respectively. Only small heterogeneity was observed for <6 months of breastfeeding (p = 0.17; Q = 18.79, $I^2=25.5%$). Compared to nulliparous women with no history of breastfeeding, the joint effects of two births and <6 months of breastfeeding resulted in a 0.5-fold reduced risk for EOC. Conclusions: The first birth and breastfeeding for <6 months were associated with significant reductions in EOC risk.

Keywords

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