Attributable causes of breast cancer and ovarian cancer in china: reproductive factors, oral contraceptives and hormone replacement therapy.
OBJECTIVE
To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors (RFs, including nulliparity, mean number of children, age at first birth and breastfeeding), use of oral contraceptives (OCs, restricted to the age group of 15-49 years), and hormone replacement therapy (HRT), as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005.


METHODS
We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China. In the case of RFs, we compared the exposure distributions in 2001 and counterfactual exposure.


RESULTS
Exposure of RFs in 2001 was found to account for 6.74% of breast cancer, corresponding to 9,617 cases and 2,769 deaths, and for 2.78% of ovarian cancer (711 cases, 294 deaths). The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer. The prevalence of OC use was 1.74% and the population attributable fraction (PAF) of breast cancer was 0.71%, corresponding to 310 cases and 90 deaths. The PAF of breast cancer due to HRT was 0.31%, resulting in 297 cases and 85 deaths.


CONCLUSIONS
RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.
Department of Gynecology, the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830011, China ; Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
Li
L
Li
Jia
J
Ji
Jian-Bing
JB
Wang
Mayineur
M
Niyazi
You-Lin
YL
Qiao
Paolo
P
Boffetta
Cancer; Hormone replacement therapy; Oral contraceptives; Population attributable fraction; Reproductive factors