Evidence map›Paper›PMID 39928248›Full record

ArticleCancer causes & control : CCC2025

Parity and breastfeeding are contributing factors for geographical differences in breast cancer risk.

Boon Hong Ang, Shivaani Mariapun, Farahida Mohd Farid, Imelda Suhanti Ishak, Muhammad Faiz Md Taib, Asfarina Ab Rahim, Lenjai Anak Jembai, Tania Islam, Kartini Rahmat, Farhana Fadzli and 4 more

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Article in Cancer causes & control : CCC, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Boon Hong AngCancer Research Malaysia, 1, Jalan SS12/1A, 47500, Subang Jaya, Malaysia.
Shivaani MariapunCancer Research Malaysia, 1, Jalan SS12/1A, 47500, Subang Jaya, Malaysia.
Farahida Mohd FaridMajlis Kanser Nasional, BG 03A & 05, Ground Floor, Megan Ambassy, 225, Jalan Ampang, 50450, Kuala Lumpur, Malaysia.
Imelda Suhanti IshakMajlis Kanser Nasional, BG 03A & 05, Ground Floor, Megan Ambassy, 225, Jalan Ampang, 50450, Kuala Lumpur, Malaysia.
Muhammad Faiz Md TaibMajlis Kanser Nasional, BG 03A & 05, Ground Floor, Megan Ambassy, 225, Jalan Ampang, 50450, Kuala Lumpur, Malaysia.
Asfarina Ab RahimMajlis Kanser Nasional, BG 03A & 05, Ground Floor, Megan Ambassy, 225, Jalan Ampang, 50450, Kuala Lumpur, Malaysia.
Lenjai Anak JembaiMajlis Kanser Nasional, BG 03A & 05, Ground Floor, Megan Ambassy, 225, Jalan Ampang, 50450, Kuala Lumpur, Malaysia.
Tania IslamDepartment of Surgery, Faculty of Medicine, University of Malaya, Jalan Universiti, 50630, Kuala Lumpur, Malaysia.
Kartini RahmatBiomedical Imaging, University of Malaya Research Imaging Centre, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Farhana FadzliBiomedical Imaging, University of Malaya Research Imaging Centre, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Nur Aishah Mohd TaibDepartment of Surgery, Faculty of Medicine, University of Malaya, Jalan Universiti, 50630, Kuala Lumpur, Malaysia.
Cheng Har YipSubang Jaya Medical Centre, No. 1, Jalan SS12/1A, 47500, Subang Jaya, Malaysia.
Weang-Kee Ho *Cancer Research Malaysia, 1, Jalan SS12/1A, 47500, Subang Jaya, Malaysia. WeangKee.Ho@nottingham.edu.my.
Soo-Hwang Teo *Cancer Research Malaysia, 1, Jalan SS12/1A, 47500, Subang Jaya, Malaysia. soo.teo@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUrbanization has emerged as one of the main determinants of the rising breast cancer incidence in Asia, but understanding the link is hindered by the lack of population-based prospective cohorts, especially in low- and middle-income countries. Given that mammographic density (MD) is one of the strongest breast cancer risk factors and that it is associated with known lifestyle and reproductive factors, we explored using MD to delineate factors associated with differences in breast cancer risk between women living in urban and rural areas.

methodsUsing data from a cross-sectional study of 9,417 women living in urban or rural areas recruited through hospital- or community-based opportunistic mammography screening programs, we conducted regression and mediation analyses to identify factors contributing to the differences in MD between urban and rural populations across Asian ethnic subgroups.

resultsConsistent with higher risk of breast cancer, age-and-BMI-adjusted percent and absolute MD measurements were significantly higher in women living in urban areas compared to those in rural areas. Mediation analyses showed that differences observed were partly explained by higher parity (7-9%) and breastfeeding (2-3%) among women living in rural areas. Notably, the effect of parity (number of children) was similar in Chinese and Malay women (16-17% and 7-8%, respectively), but not observed in Indian women. Hormonal use, smoking, and physical activity did not predict MD nor mediate the observed association.

conclusionHigher MD among women living in urban compared to rural areas is partially attributable to parity and breastfeeding practices, a significant proportion of attributable risk remains unknown.

Indexed as

Breast FeedingBreast NeoplasmsParityAdultBreast DensityCross-Sectional StudiesFemaleHumansMammographyMiddle AgedPregnancyRisk FactorsRural PopulationUrban PopulationBreast cancerBreastfeedingMammographic densityParityUrbanization

Identifiers

PMID39928248

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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.