title: Breastfeeding, menopause, and epithelial ovarian cancer.
abstract: No previous study has examined the modifying effect of menopausal status on the association between lactation and ovarian cancer risk. We recruited 824 epithelial ovarian cancer cases and 855 community controls in three Australian states, collecting reproductive and lactation histories by means of a contraceptive calendar and pregnancy and breastfeeding record. We report results in women with at least one liveborn infant for unsupplemented breastfeeding, in line with a biological model linking suppression of ovulation to reduction in ovarian cancer risk. We derived odds ratios from multiple logistic regression models including number of liveborn children, age, age at first or last birth, and other potential confounders, overall and by menopausal status. Estimates of relative risk of ovarian cancer per month of full lactation were 0.99 [95% confidence interval (CI) = 0.97-1.00] overall and 1.00 (95% CI = 0.99-1.01) and 0.98 (95% CI = 0.95-1.01) among post- and premenopausal women, respectively. We tailored a lactation variable to the incessant ovulation hypothesis by progressively discounting breastfeeding the longer after birth it occurred, finding odds ratios similar to those for the unmodified duration variable. We found no association of note among postmenopausal women. Breastfeeding seems to be somewhat protective against ovarian cancer, but only before menopause.
authors.affiliation: Department of Social and Preventive Medicine, University of Queensland, Australia.
authors.forename: V
authors.initials: V
authors.lastname: Siskind
authors.forename: A
authors.initials: A
authors.lastname: Green
authors.forename: C
authors.initials: C
authors.lastname: Bain
authors.forename: D
authors.initials: D
authors.lastname: Purdie
mesh_terms: D000328:Adult; D017668:Age of Onset; D001315:Australia / Q000453:epidemiology; D001942:Breast Feeding; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires