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Being Breastfed in Infancy and Risk of Colorectal Cancer and Precursor Lesions

Yuan, Chen ; Wang, Qiao-Li LU orcid ; Kim, Hanseul ; Babic, Ana ; Zhang, Jinming ; Wolpin, Brian M ; Wu, Kana ; Song, Mingyang ; Ogino, Shuji and Meyerhardt, Jeffrey A , et al. (2024) In Clinical Gastroenterology and Hepatology 22(7). p.11-1517
Abstract

BACKGROUND & AIMS: Emerging evidence implicates the importance of perinatal and early-life exposures in colorectal cancer (CRC) development. However, it remains unclear whether being breastfed in infancy is associated with CRC risk in adult life, particularly early adulthood.

METHODS: We prospectively investigated the association between history of being breastfed and risk of CRC and its precursor lesions among 66,634 women 46-93 years of age from the Nurses' Health Study and 92,062 women 27-68 years of age from the Nurses' Health Study II. Cox regression and logistic regression for clustered data were used to estimate hazard ratios for CRC and odds ratios for CRC precursors, respectively.

RESULTS: During 3.5 million... (More)

BACKGROUND & AIMS: Emerging evidence implicates the importance of perinatal and early-life exposures in colorectal cancer (CRC) development. However, it remains unclear whether being breastfed in infancy is associated with CRC risk in adult life, particularly early adulthood.

METHODS: We prospectively investigated the association between history of being breastfed and risk of CRC and its precursor lesions among 66,634 women 46-93 years of age from the Nurses' Health Study and 92,062 women 27-68 years of age from the Nurses' Health Study II. Cox regression and logistic regression for clustered data were used to estimate hazard ratios for CRC and odds ratios for CRC precursors, respectively.

RESULTS: During 3.5 million person-years of follow-up, we identified 1490 incident cases of CRC in 2 cohorts. Having been breastfed was associated with a 23% (95% confidence interval [CI], 10% to 38%) increased risk of CRC. The risk of CRC increased with duration of being breastfed (Ptrend < .001). These findings were validated using breastfeeding information from the mothers of a subset of participants. Among younger participants from the Nurses' Health Study II, a significant association was observed between being breastfed and increased risk of high-risk adenomas under 50 years of age (odds ratio, 1.46; 95% CI, 1.16 to 1.83). Consistently, having been breastfed was associated with increased risk of CRC among participants ≤55 years of age (hazard ratio, 1.38; 95% CI, 1.06 to 1.80).

CONCLUSIONS: Being breastfed in infancy was associated with increased risk of CRC in adulthood, including among younger adults. However, further research is needed to understand the underlying biological mechanisms, as this association does not establish causation.

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publishing date
type
Contribution to journal
publication status
published
keywords
Humans, Breast Feeding/statistics & numerical data, Female, Middle Aged, Colorectal Neoplasms/epidemiology, Prospective Studies, Adult, Aged, Aged, 80 and over, Risk Assessment, Infant
in
Clinical Gastroenterology and Hepatology
volume
22
issue
7
pages
11 - 1517
publisher
Elsevier
external identifiers
  • scopus:85176144336
  • pmid:37683882
ISSN
1542-7714
DOI
10.1016/j.cgh.2023.08.023
language
English
LU publication?
no
additional info
Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.
id
9cdcf1f5-ff14-47cb-b8a6-b91b5eee1999
date added to LUP
2025-05-12 17:11:23
date last changed
2025-07-08 09:54:02
@article{9cdcf1f5-ff14-47cb-b8a6-b91b5eee1999,
  abstract     = {{<p>BACKGROUND &amp; AIMS: Emerging evidence implicates the importance of perinatal and early-life exposures in colorectal cancer (CRC) development. However, it remains unclear whether being breastfed in infancy is associated with CRC risk in adult life, particularly early adulthood.</p><p>METHODS: We prospectively investigated the association between history of being breastfed and risk of CRC and its precursor lesions among 66,634 women 46-93 years of age from the Nurses' Health Study and 92,062 women 27-68 years of age from the Nurses' Health Study II. Cox regression and logistic regression for clustered data were used to estimate hazard ratios for CRC and odds ratios for CRC precursors, respectively.</p><p>RESULTS: During 3.5 million person-years of follow-up, we identified 1490 incident cases of CRC in 2 cohorts. Having been breastfed was associated with a 23% (95% confidence interval [CI], 10% to 38%) increased risk of CRC. The risk of CRC increased with duration of being breastfed (Ptrend &lt; .001). These findings were validated using breastfeeding information from the mothers of a subset of participants. Among younger participants from the Nurses' Health Study II, a significant association was observed between being breastfed and increased risk of high-risk adenomas under 50 years of age (odds ratio, 1.46; 95% CI, 1.16 to 1.83). Consistently, having been breastfed was associated with increased risk of CRC among participants ≤55 years of age (hazard ratio, 1.38; 95% CI, 1.06 to 1.80).</p><p>CONCLUSIONS: Being breastfed in infancy was associated with increased risk of CRC in adulthood, including among younger adults. However, further research is needed to understand the underlying biological mechanisms, as this association does not establish causation.</p>}},
  author       = {{Yuan, Chen and Wang, Qiao-Li and Kim, Hanseul and Babic, Ana and Zhang, Jinming and Wolpin, Brian M and Wu, Kana and Song, Mingyang and Ogino, Shuji and Meyerhardt, Jeffrey A and Chan, Andrew T and Cao, Yin and Giovannucci, Edward L and Ng, Kimmie}},
  issn         = {{1542-7714}},
  keywords     = {{Humans; Breast Feeding/statistics & numerical data; Female; Middle Aged; Colorectal Neoplasms/epidemiology; Prospective Studies; Adult; Aged; Aged, 80 and over; Risk Assessment; Infant}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{11--1517}},
  publisher    = {{Elsevier}},
  series       = {{Clinical Gastroenterology and Hepatology}},
  title        = {{Being Breastfed in Infancy and Risk of Colorectal Cancer and Precursor Lesions}},
  url          = {{http://dx.doi.org/10.1016/j.cgh.2023.08.023}},
  doi          = {{10.1016/j.cgh.2023.08.023}},
  volume       = {{22}},
  year         = {{2024}},
}