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Meta-Analysis
. 2020 Oct 21;41(4).
doi: 10.1515/hmbci-2020-0021.

Breast cancer risk factors in Iran: a systematic review & meta-analysis

Amir Shamshirian  1   2 , Keyvan Heydari  2   3 , Zahra Shams  4 , Amir Reza Aref  5 , Danial Shamshirian  6 , Omid Reza Tamtaji  7 , Zatollah Asemi  7 , Layla Shojaie  8 , Hamed Mirzaei  7 , Neda Mohammadi  9 , Behdad Zibaee  10 , Keyvan Karimifar  11 , Bahman Zarandi  12 , Akbar Hedayatizadeh-Omran  2 , Reza Alizadeh-Navaei  2
Affiliations
Free article
Meta-Analysis

Breast cancer risk factors in Iran: a systematic review & meta-analysis

Amir Shamshirian et al. Horm Mol Biol Clin Investig. .
Free article

Abstract

Objectives: Breast cancer is known as one of the deadliest forms of cancer, and it is increasing globally. There are a variety of proven and controversial risk factors for this malignancy. Herein, we aimed to undertake a systematic review and meta-analysis focus on the epidemiology of breast cancer risk factors in Iran.

Methods: We performed a systematic search via PubMed, Scopus, Web of Science, and Persian databases for identifying studies published on breast cancer risk factors up to March 2019. Meta-analyses were done for risk factors reported in more than one study. We calculated odds ratios (ORs) with corresponding 95% confidence intervals (CIs) using a fixed/random-effects models.

Results: Thirty-nine studies entered into the meta-analysis. Pooling of ORs showed a significant harmful effect for risk factors including family history (OR: 1.80, 95%CI 1.47-2.12), hormonal replacement therapy (HRT) (OR: 5.48, 95%CI 0.84-1.74), passive smokers (OR: 1.68, 95%CI 1.34-2.03), full-term pregnancy at age 30 (OR: 3.41, 95%CI 1.19-5.63), abortion (OR: 1.84, 95%CI 1.35-2.33), sweets consumption (OR: 1.71, 95%CI 1.32-2.11) and genotype Arg/Arg (crude OR: 1.59, 95%CI 1.07-2.10), whereas a significant protective effect for late menarche (OR: 0.58, 95%CI 0.32-0.83), nulliparity (OR: 0.68, 95%CI 0.39-0.96), 13-24 months of breastfeeding (OR: 0.68, 95%CI 0.46-0.90), daily exercise (OR: 0.59, 95%CI 0.44-0.73) and vegetable consumption (crude OR: 0.28, 95%CI 0.10-0.46).

Conclusions: This study suggests that factors such as family history, HRT, passive smokers, late full-term pregnancy, abortion, sweets consumption and genotype Arg/Arg might increase risk of breast cancer development, whereas late menarche, nulliparity, 13-24 months breastfeeding, daily exercise and vegetable consumption had an inverse association with breast cancer development.

Keywords: breast carcinoma; breast tumor; mammary neoplasm; meta-analysis; population at risk.

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