Systematic review and meta analysis of reproductive health factors associated with breast cancer among women in Ethiopia

Abstract

Several modifiable reproductive factors have been linked to the development of breast cancer; however, the evidence regarding the association between certain reproductive-related factors and breast cancer risk remains inconsistent. Therefore, we conducted a systematic review and meta-analysis to synthesize the available evidence. A systematic review and meta-analysis. Electronic databases, including PubMed/Medline, Scopus, Web of Science, ScienceDirect, and Google Scholar search engine, were used to retrieve relevant articles. All case-control studies conducted in Ethiopia that reported reproductive factors associated with breast cancer in women—regardless of the tumor’s pathological characteristics or stage—were included in this meta-analysis. The Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument was used for the critical appraisal. Two independent reviewers extracted the data using a standardized data extraction format. Stata version 17 software was used for the data analysis. Cochran’s Q statistic with inverse variance (I2) and Egger’s test were used to assess the presence of heterogeneity. Publication bias was checked using Egger’s test, with p < 0.05 considered statistically significant. A random effects model was used to estimate pooled effects with a 95% CI. Overall, eight eligible articles with 2,314 women were included to identify reproductive health-related factors of breast cancer among women in Ethiopia. As a result, having breastfeeding experience was significantly associated with decreased risk of breast cancer in women (OR: 0.74; 95% CI 0.59, 0.92). Whereas, a history of abortion (OR: 2.22; 95% CI 1.17, 4.22) and oral contraceptive use (OR: 1.40; CI 1.02, 1.98) were significantly associated with higher odds of breast cancer in women. Egger’s test indicated no publication bias (p > 0.05). This review demonstrated that breastfeeding experience was associated with a significant reduction in the odds of breast cancer. In contrast, the use of oral contraceptives and a history of abortion were both linked to significantly increased odds of breast cancer. Therefore, policymakers and healthcare providers should strengthen public health interventions that promote breastfeeding and increase awareness and counseling related to reproductive health.