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Pregnancy Termination in Relation to Risk of Breast Cancer
Polly A. Newcomb, PhD;
Barry E. Storer, PhD;
Matthew P. Longnecker, MD;
Robert Mittendorf, MD;
E. Robert Greenberg, MD;
Walter C. Willett, MD
JAMA. 1996;275(4):283-287.
Abstract
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Objective.
—To evaluate the association between pregnancy terminations and risk of breast cancer.
Design and Setting.
—Population-based case-control study in Wisconsin, Massachusetts, Maine, and New Hampshire.
Study Participants.
—Cases were women younger than 75 years with a new diagnosis of breast cancer (n=6888), identified from statewide tumor registries. Controls younger than 65 years (n=9529) were randomly selected from lists of licensed drivers, or for older subjects, from lists of Medicare beneficiaries. Exposures and Outcomes.—Breast cancer risk in relation to spontaneous or induced abortions.
Results.
—After adjustment for parity, age at first birth, and other risk factors, pregnancy termination (induced or spontaneous) was associated with a relative risk (RR) of breast cancer of 1.12 (95% confidence interval [CI], 1.04 to 1.21), compared with the risk among women who had never had a termination. Induced terminations were associated with a RR of 1.23 (95% CI, 1.00 to 1.51), which was somewhat greater than the risk associated with spontaneous terminations (RR, 1.11; 95% CI, 1.02 to 1.20). The association with induced abortions was stronger for those performed before legalization of abortion in 1973 (RR, 1.35; 95% CI, 1.01 to 1.80) than after this time (RR, 1.12; 95% CI, 0.84 to 1.49), suggesting a bias in reporting this sensitive procedure.
Conclusions.
—A weak positive association was observed between abortion— whether induced or spontaneous—and risk of breast cancer. The increase in risk of breast cancer was somewhat greater among women with a history of induced terminations. However, this association may be due to reporting bias and was not significantly different than the slight risk for spontaneous terminations.
(JAMA. 1996;275:283-287)
Author Affiliations
From the University of Wisconsin Comprehensive Cancer Center, Madison, and Fred Hutchinson Cancer Research Center, Seattle, Wash (Drs Newcomb and Storer); Department of Epidemiology, UCLA School of Public Health, Los Angeles, Calif (Dr Longnecker); Department of Obstetrics and Gynecology, University of Chicago (Ill), Chicago Lying-In Hospital (Dr Mittendorf); Norris Cotton Cancer Center, Dartmouth Hitchcock Medical School, Hanover, NH (Dr Greenberg); and Department of Nutrition, Harvard School of Public Health, Channing Laboratory, Harvard Medical School, and Department of Medicine, Brigham and Women's Hospital, Boston, Mass (Dr Willett). Dr Longnecker is now at the Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC.
Footnotes
Presented in part at the 28th annual meeting of the Society for Epidemiologic Research, Snowbird, Utah, June 22, 1995.
Reprint requests to University of Wisconsin Comprehensive Cancer Center, Room 4780, Medical Science Center, 1300 University Ave, Madison, WI 53706 (Dr Newcomb).
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