Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)

The association between parity and breast cancer has been widely investigated in high-income countries. However, in sub-Saharan African (SSA) region, only a few studies have investigated this association. The aim of this study was to critically review the available evidence, highlighting their stren...

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Main Author: Samuel Onyinyechukwu Azubuike
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:International Journal of Noncommunicable Diseases
Subjects:
Online Access:http://www.ijncd.org/article.asp?issn=2468-8827;year=2023;volume=8;issue=2;spage=66;epage=74;aulast=Azubuike
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author Samuel Onyinyechukwu Azubuike
author_facet Samuel Onyinyechukwu Azubuike
author_sort Samuel Onyinyechukwu Azubuike
collection DOAJ
description The association between parity and breast cancer has been widely investigated in high-income countries. However, in sub-Saharan African (SSA) region, only a few studies have investigated this association. The aim of this study was to critically review the available evidence, highlighting their strength and weakness, thereby providing a basis for more studies in SSA on the topic. A literature search in MEDLINE, Scopus, PubMed, Google Scholar, and reference list of published studies was conducted. Key case control and cohort studies published between 2000 and 2018 were selected for detailed review based on sample size, geographical distributions, and relevance of the findings. Nonanalytical studies were excluded. The findings were summarized using the tables and forest plots based on R Statistical Software version 3.4.0 (2017). This was primarily to provide visual overview of the reviewed studies and not necessarily to provide a pooled estimate. The conclusion was drawn by comparing the number of observed significant findings (assessed based on confidence intervals) with the number of nonsignificant findings across countries and SSA taking into considerations their strengths and weaknesses. Twenty-six case − control studies and 12 cohort studies across the four regions of the world North America, Europe, Asia, and Africa were reviewed. A reduced risk of breast cancer (especially estrogen receptor [ER] positive breast cancer) was observed in most studies, especially studies from high-income countries. While several studies that reported a nonsignificant observation in SSA were limited in sample size, the few that observed a reduced risk of breast with parity among all women were subject to confounding. Nevertheless, recent studies suggest that the role of parity may be modified by ER status and menopausal status. Further investigation of these suggestions will be needed for a clearer understanding of the relationship between parity and breast cancer in SSA.
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spelling doaj.art-e6bc07470fcc40429707149c3c678fd92023-07-23T11:15:28ZengWolters Kluwer Medknow PublicationsInternational Journal of Noncommunicable Diseases2468-88272468-88352023-01-0182667410.4103/jncd.jncd_6_23Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)Samuel Onyinyechukwu AzubuikeThe association between parity and breast cancer has been widely investigated in high-income countries. However, in sub-Saharan African (SSA) region, only a few studies have investigated this association. The aim of this study was to critically review the available evidence, highlighting their strength and weakness, thereby providing a basis for more studies in SSA on the topic. A literature search in MEDLINE, Scopus, PubMed, Google Scholar, and reference list of published studies was conducted. Key case control and cohort studies published between 2000 and 2018 were selected for detailed review based on sample size, geographical distributions, and relevance of the findings. Nonanalytical studies were excluded. The findings were summarized using the tables and forest plots based on R Statistical Software version 3.4.0 (2017). This was primarily to provide visual overview of the reviewed studies and not necessarily to provide a pooled estimate. The conclusion was drawn by comparing the number of observed significant findings (assessed based on confidence intervals) with the number of nonsignificant findings across countries and SSA taking into considerations their strengths and weaknesses. Twenty-six case − control studies and 12 cohort studies across the four regions of the world North America, Europe, Asia, and Africa were reviewed. A reduced risk of breast cancer (especially estrogen receptor [ER] positive breast cancer) was observed in most studies, especially studies from high-income countries. While several studies that reported a nonsignificant observation in SSA were limited in sample size, the few that observed a reduced risk of breast with parity among all women were subject to confounding. Nevertheless, recent studies suggest that the role of parity may be modified by ER status and menopausal status. Further investigation of these suggestions will be needed for a clearer understanding of the relationship between parity and breast cancer in SSA.http://www.ijncd.org/article.asp?issn=2468-8827;year=2023;volume=8;issue=2;spage=66;epage=74;aulast=Azubuikebreast cancerparitysub-saharan africa
spellingShingle Samuel Onyinyechukwu Azubuike
Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)
International Journal of Noncommunicable Diseases
breast cancer
parity
sub-saharan africa
title Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)
title_full Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)
title_fullStr Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)
title_full_unstemmed Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)
title_short Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)
title_sort relationship between parity and breast cancer risk a critical review of evidence with focus on sub saharan africa
topic breast cancer
parity
sub-saharan africa
url http://www.ijncd.org/article.asp?issn=2468-8827;year=2023;volume=8;issue=2;spage=66;epage=74;aulast=Azubuike
work_keys_str_mv AT samuelonyinyechukwuazubuike relationshipbetweenparityandbreastcancerriskacriticalreviewofevidencewithfocusonsubsaharanafrica