Greater family size is associated with less cancer risk: an ecological analysis of 178 countries

Abstract

BackgroundGreater family size measured with total fertility rate (TFR) and with household size, may offer more life satisfaction to the family members. Positive psychological well-being has been postulated to decrease cancer initiation risk. This ecological study aims to examine the worldwide correlation between family size, used as the measure of positive psychological well-being, and total cancer incidence rates.MethodsCountry specific estimates obtained from United Nations agencies on total cancer incidence rates (total, female and male rates in age range 0–49 years and all ages respectively), all ages site cancer incidence (bladder, breast, cervix uteri, colorectum, corpus uteri, lung, ovary and stomach), TFR, household size, life expectancy, urbanization, per capita GDP PPP and self-calculated Biological State Index (Ibs) were matched for data analysis. Pearson’s, non-parametric Spearman’s, partial correlations, independent T-test and multivariate regressions were conducted in SPSS.ResultsWorldwide, TFR and household size were significantly and negatively correlated to all the cancer incidence variables. These correlations remained significant in partial correlation analysis when GDP, life expectancy, Ibs and urbanization were controlled for. TFR correlated to male cancer incidence rate (all ages) significantly stronger than it did to female cancer incidence rate (all ages) in both Pearson’s and partial correlations. Multivariate stepwise regression analysis indicated that TFR and household size were consistently significant predictors of all cancer incidence variables.ConclusionsCountries with greater family size have lower cancer risk in both females, and especially males. Our results seem to suggest that it may be worthwhile further examining correlations between family size and cancer risk in males and females through the cohort and case-control studies based on large samples.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4837-0) contains supplementary material, which is available to authorized users.

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“…86 Although the literature remains contradictory as to the protective effect of parity on breast cancer given its dual effect on this risk, 100 there is strong evidence from HICs and to a lesser extent, from LMICs, that more childbearing (greater TFR) and larger family size may contribute to developing cervical cancer, with the reverse being true for uterine and ovarian cancers. 101 Furthermore, with widespread rapid and unplanned urbanization, current public health paradigm delineates the various environmental hazards of urbanicity as the key drivers of urban women's excess NCD morbidity and mortality of premature onset from major causes (cancer, CVD, diabetes, and respiratory diseases). 10,11 An increasing interest has recently gained the role of ambient air pollution and noise from mass motorization, heat islands from impervious surface areas and less open green spaces, light pollution by artificial light at night, and a broad suite of obesogenic factors such as urban sprawl, street connectivity and fast food outlet abundance, alongside other attributes of built and social (e.g.…”

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“…1) Biological State Index (I bs ), estimating the magnitude of accumulation of obesity genetic background and other obesity associated deleterious genes in a population due to relaxed natural selection [21,23,37,38] Ibs calculation was based on the fertility data of each country published by United Nations in 2008 [39][40][41] and the mortality data of life tables (2009) published by World Health Organization (WHO) in 2012 [42]. These calculations were the same as in the previous study published by Budnik and Henneberg [23].…”

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“…5) Low fertility rates have been associated with cancer risks in both females and males [111][112][113]. Fertility rates in Australia and New Zealand are much lower than in many other countries.…”