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BMC Medicine
Published in: BMC Medicine 1/2021

01-12-2021 | Lymphoma | Research article

Breastfeeding and the risk of childhood cancer: a systematic review and dose-response meta-analysis

Authors: Qing Su, Xiaohui Sun, Liwen Zhu, Qin Yan, Peiwen Zheng, Yingying Mao, Ding Ye

Published in: BMC Medicine | Issue 1/2021

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Abstract

Background

The aim of this study was to quantitatively summarize the available evidence on the association of breastfeeding with the risk of childhood cancer.

Methods

A literature search of PubMed and Embase databases was performed to identify eligible observational studies published from inception to July 17, 2020. The categorical and dose-response meta-analysis was conducted by pooling relative risk (RR) or odds ratio (OR) estimates with 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression and stratification analysis. Sensitivity analysis and publication bias test were also carried out.

Results

Forty-five articles involving 475,579 individuals were included in the meta-analysis. Among the thirty-three studies on the association between breastfeeding and risk of childhood leukemia, the pooled risk estimates were 0.77 (95% CI, 0.65–0.91) and 0.77 (95% CI 0.63–0.94) for ever versus non/occasional breastfeeding and longest versus shortest breastfeeding duration group, respectively. There was clear indication for non-linear dose-response relationship between breastfeeding duration and the risk of childhood leukemia (P non-linear < 0.001). The most protective effect (OR, 0.66, 95% CI 0.62–0.70) was observed at a breastfeeding duration of 9.6 months. Four studies examined, the association between breastfeeding and risk of childhood neuroblastoma, and significant inverse associations were consistently observed in both the comparisons of ever breastfeeding versus non/occasional breastfeeding (OR = 0.59, 95% CI 0.44–0.81) and longest versus shortest breastfeeding (OR = 0.61, 95% CI 0.44–0.83). However, no associations of breastfeeding with risk of other cancers were found.

Conclusions

Our study supports a protective role of breastfeeding on the risk of childhood leukemia, also suggesting a non-linear dose-response relationship. Further studies are warranted to confirm the association between breastfeeding and risk of childhood neuroblastoma.
Appendix
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Metadata
Title
Breastfeeding and the risk of childhood cancer: a systematic review and dose-response meta-analysis
Authors
Qing Su
Xiaohui Sun
Liwen Zhu
Qin Yan
Peiwen Zheng
Yingying Mao
Ding Ye
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2021
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-021-01950-5

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