ArticleBMC public health2021
The causal effect and impact of reproductive factors on breast cancer using super learner and targeted maximum likelihood estimation: a case-control study in Fars Province, Iran.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 19 citations in OpenAlex.
- Protective effect of intensive glucose lowering therapy on all-cause mortality, adjusted for treatment switching using G-estimation method, the ACCORD trial.Scientific reports · 2023Trial
- Use of causal inference methods in case-control studies: a methodology review.American journal of epidemiology · 2026Review
- Association of reproductive and menstrual factors with the risk of breast cancer in women: a population-based study.BMC cancer · 2025Article
- Bayesian Spatial Analysis of the Incidence Rate of Patients with Breast Cancer in Southern Iran.Iranian journal of medical sciences · 2025Article
- Comparison of outcomes between off-pump and on-pump coronary artery bypass graft surgery using collaborative targeted maximum likelihood estimation.Scientific reports · 2024Article
- Hormonal Contraception and the Risk of Breast Cancer in Women of Reproductive Age: A Meta-Analysis.Cancers · 2023Review
- The effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the Iranian population.BMC public health · 2023Article
- Impact of Alcohol Consumption on Multiple Sclerosis Using Model-based Standardization and Misclassification Adjustment Via Probabilistic Bias Analysis.Archives of Iranian medicine · 2023Article
- Effect of alcohol consumption on breast cancer: probabilistic bias analysis for adjustment of exposure misclassification bias and confounders.BMC medical research methodology · 2023Article
- Temporal Pattern and Age-Period-Cohort Analysis of Breast Cancer Incidence in Iranian Women (2009-2017).Archives of Iranian medicine · 2023Article
- The role of breastfeeding in breast cancer prevention: a literature review.Frontiers in oncology · 2023Review
- Longitudinal effects of lipid indices on incident cardiovascular diseases adjusting for time-varying confounding using marginal structural models: 25 years follow-up of two US cohort studies.Global epidemiology · 2022Article
- Article
- Population attributable fraction in textbooks: Time to revise.Global epidemiology · 2021Article
- The Effects of Smoking on Metabolic Syndrome and Its Components Using Causal Methods in the Iranian Population.International journal of preventive medicine · 2021Article
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe relationship between reproductive factors and breast cancer (BC) risk has been investigated in previous studies. Considering the discrepancies in the results, the aim of this study was to estimate the causal effect of reproductive factors on BC risk in a case-control study using the double robust approach of targeted maximum likelihood estimation.
methodsThis is a causal reanalysis of a case-control study done between 2005 and 2008 in Shiraz, Iran, in which 787 confirmed BC cases and 928 controls were enrolled. Targeted maximum likelihood estimation along with super Learner were used to analyze the data, and risk ratio (RR), risk difference (RD), andpopulation attributable fraction (PAF) were reported.
resultsOur findings did not support parity and age at the first pregnancy as risk factors for BC. The risk of BC was higher among postmenopausal women (RR = 3.3, 95% confidence interval (CI) = (2.3, 4.6)), women with the age at first marriage ≥20 years (RR = 1.6, 95% CI = (1.3, 2.1)), and the history of oral contraceptive (OC) use (RR = 1.6, 95% CI = (1.3, 2.1)) or breastfeeding duration ≤60 months (RR = 1.8, 95% CI = (1.3, 2.5)). The PAF for menopause status, breastfeeding duration, and OC use were 40.3% (95% CI = 39.5, 40.6), 27.3% (95% CI = 23.1, 30.8) and 24.4% (95% CI = 10.5, 35.5), respectively.
conclusionsPostmenopausal women, and women with a higher age at first marriage, shorter duration of breastfeeding, and history of OC use are at the higher risk of BC.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.