Background: Incidence of breast cancer (BrCa) may be correlated with country development, with a rise in cases anticipated in regions of the world that are currently undergoing an economic transformation. Herein, differences with regard to the occurrence of breast cancer between individual countries may depend on the distribution of risk factors, the level of early detection, also ethnicity and race, as well as clinical characteristics. The aim of our study was to identify and then investigate observational studies in which the risk of breast cancer was associated with the use of oral hormonal contraceptives (OCs), with particular emphasis on geographic region, and to conduct a systematic review and meta-analysis of the obtained data.Methods: RR (relative risk) was calculated and displayed in forest plots for visual interpretation. Accordingly, 74 studies involving a total of 198,579 women were eligible for inclusion in the meta-analysis. This is the first meta-analysis to comprehensively summarize the evidence between OC use and BrCa risk in connection with geographical region.Results: The cumulative results of the meta-analysis for specific parts of the world are: Africa (RR = 1.16,p= 0.216) and the Americas (RR = 1.03,p= 0.597); Asia (RR = 1.29,p= 0.014); European countries (RR = 1.01,p= 0.904); and Middle East countries (RR = 1.29,p= 0.043). Subgroup analyses showed an increased risk of BrCa for the analyzed variables that depended upon the geographical region.Conclusions: Our meta-analysis suggests that OC use may be associated with a higher BrCa risk, although a statistically significant association was not found for all geographical regions of the world.
背景：乳腺癌的发病率可能与国家发展水平相关，预计当前经历经济转型的地区病例数将有所上升。各国乳腺癌发病率的差异可能取决于风险因素的分布、早期检测水平、种族与民族以及临床特征。本研究旨在识别并调查口服激素避孕药使用与乳腺癌风险相关的观察性研究，特别关注地理区域因素，并对所获数据进行系统综述和荟萃分析。 方法：计算相对风险值，并通过森林图进行可视化呈现。最终纳入74项研究，共计198,579名女性参与荟萃分析。这是首个系统综合不同地理区域口服避孕药使用与乳腺癌风险关联证据的荟萃分析。 结果：全球特定区域的荟萃分析累积结果显示：非洲（RR=1.16，p=0.216）和美洲（RR=1.03，p=0.597）；亚洲（RR=1.29，p=0.014）；欧洲国家（RR=1.01，p=0.904）；中东国家（RR=1.29，p=0.043）。亚组分析显示，根据地理区域划分的分析变量均呈现乳腺癌风险上升趋势。 结论：本荟萃分析表明口服避孕药使用可能与较高的乳腺癌风险相关，但并非全球所有地理区域均呈现统计学显著关联。
肿瘤(癌症)患者之家