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Background/Objective: India is theworld's most biodiverse region and is undergoing aperiod of dramatic social and economic change. Dueto population's explosion, climate change and laximplementation of environmental policies, theincidence of breast cancer is increasing. Frompopulation-based cancer registry data, breastcancer is the most common cancer in women in urbanregistries where it constitutes more than 30% ofall cancers in females. We conducted ameta-analysis of all breast cancer case–controlstudies conducted in India during 1991–2018 tofind pooled estimates of odds ratio (OR).Materials and Methods: Eligible studies wereidentified through a comprehensive literaturesearch of PubMed, EMBASE, and HINARI databasesfrom 1991 to January 2018. This analysis included24 observational studies out of 34 that reportedthe case–control distribution of reproductivefactors, body mass index (BMI) and type ofresidence. The analysis was performed using RevMan5.3 (Review Manager, 2017) applying therandom-effects model. Results: A total of 21,511patients (9889 cases and 11,622 controls) wereanalyzed, resulting in statistically significantassociation between breast cancer and thefollowing reproductive factors: never breastfeed(OR: 3.69; 95% confidence interval [CI]: 1.70,8.01), menopausal age &gt;50 years (OR: 2.88; 95%CI: 1.85, 3.85), menarche age &lt;13 years (OR:1.83; 95% CI: 1.34, 2.51), null parity (OR: 1.58;95% CI: 1.21, 2.06), postmenopause (OR: 1.35; 95%CI: 1.13, 1.62), and age at the 1st pregnancy&gt;25 years (OR: 1.57; 95% CI: 1.37, 1.80).Family history (FH) of breast cancer (OR: 5.33;95% CI: 2.89, 9.82), obesity (OR: 1.19; 95% CI:1.00, 1.42), and urban residence (OR: 1.22; 95%CI: 1.03, 1.44) were also found to be significantrisk factors. Conclusion: The results of thismeta-analysis are indicative of significantassociations between reproductive factors andbreast cancer risk, profoundly so among womenexperiencing menopause after the age of 50, womenwho never breastfeed and FH of breastcancer.

Reproductive factors and breast cancer risk: A meta-analysis of case–control studies in Indian women