title: Tubal sterilization and breast cancer incidence: results from the cancer prevention study II nutrition cohort and meta-analysis.
abstract: Tubal sterilization is a common form of contraception in the United States and is hypothesized to be associated with a lower risk of breast cancer. However, prior observational studies have reported inconsistent results. We investigated the association between tubal sterilization and breast cancer risk among 77,249 postmenopausal, cancer-free women in the Cancer Prevention Study II (CPS-II) Nutrition Cohort, enrolled in 21 states in the United States during 1992-1993. During 15 years of follow-up through June 30, 2007, 4,084 invasive breast cancer cases were diagnosed. Multivariable Cox proportional hazard regression was used to estimate hazard ratios and 95% confidence intervals. A meta-analysis including the CPS-II Nutrition Cohort results with other published results from 4 case-control studies and 3 prospective studies was conducted to provide a summary estimate for the association between tubal sterilization and breast cancer risk. In the CPS-II Nutrition Cohort, tubal sterilization was not associated with breast cancer incidence (multivariable-adjusted hazard ratio = 1.08, 95% confidence interval: 0.97, 1.20). Associations stratified by year of tubal sterilization, age, and time since surgery were also null. The meta-analysis also found no association between tubal sterilization and breast cancer risk (odds ratio = 0.97, 95% confidence interval: 0.84, 1.09). Tubal sterilization does not appear to be associated with breast cancer risk.
authors: American Cancer Society, 250 Williams Street, Atlanta, GA 30316, USA. mia.gaudet@cancer.org
authors: Mia M
authors: MM
authors: Gaudet
authors: Alpa V
authors: AV
authors: Patel
authors: Juzhong
authors: J
authors: Sun
authors: Lauren R
authors: LR
authors: Teras
authors: Susan M
authors: SM
authors: Gapstur
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D013246:Sterilization, Tubal / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology