Reproductive Factors and Breast Cancer Risk in Palestine: A Case-control Study

Abstract

Background: Early age at menarche, late age at menopause, and late age at first full-term pregnancy are linked to a modest increase in the risk of developing breast cancer (breast ca). Multiparity is related to an increased risk but multiple full-term pregnancies decrease the risk of breast cancers. This study aims to investigate the reproductive determinants of breast cancer among women in the West Bank of Palestine.Methods: A structured questionnaire was used to collect data in a case-control study; 237 registered cases and 237 controls aged 40 years old or more. A multivariate analysis model was used to adjust for the association between women’s reproductive factors and breast ca risk. Adjusted odds ratio (AOR) and 95% confidence interval (95% CI) are reported. This study was approved by Al Quds University Ethical Research Committee and the Ministry of Health research unit. All women provided written informed consent.Results: In the multivariate analysis, having menarche after 13 years of age, using oral contraceptives for more than two months, using hormone replacement therapy (HRT), and getting pregnant at an early age (≤18 years) significantly doubled the risk for breast ca. Women who used hormonal contraceptives were significantly associated with higher odds of having breast ca 6.37 compared to those who did not use them (p <0.05). Similarly, nulliparous women showed 6 times the odds of breast ca be compared with women with one or more children (p = 0.005). Also, the mother’s educational level; parental consanguinity marriage; and positive family history of breast ca be strong determinants for breast ca in this study. Conclusions: This study provides clear evidence of the role of using oral contraceptives and hormonal replacement therapy on women's breasts ca. Therefore, reproductive hormones use, whether as a birth control tool or in therapy, must be rationalized. More in-depth investigations are needed to identify the protective role of having children and breastfeeding practices on breast ca protection. Special attention should be considered for the special social and cultural factors related to sexual and reproductive issues among women in Palestine