A prospective study of induced abortion and breast cancer in African-American women

OBJECTIVE: There continues to be controversy about whether induced abortion influences the risk of breast cancer. Because case-control studies of this relation are subject to recall bias, there is a need for prospective data. Further, there has been little study of abortion and breast cancer in African-American women. We assessed the relation of abortion to risk of breast cancer in a prospective follow-up study of African-American women. METHODS: Black Women's Health Study participants have been followed by mailed questionnaires every two years since enrollment in 1995. Participants reported 348 incident breast cancers during 205,983 person-years of follow-up. Women who had an induced abortion were compared with women who had never had one, with nulliparous and parous women analyzed separately. Incidence rate ratios (IRR) with two-sided 95% confidence intervals (CI) were derived from Cox regression models that controlled for age, age at first birth, number of births, history of spontaneous abortion, and other factors. RESULTS: Among nulliparous women, the IRR for any induced abortion relative to none was 0.9 (95% CI = 0.5-1.4), and among parous women, the comparable IRR was 1.1 (95% CI = 0.8-1.4). Risk did not vary by number of abortions, age at first abortion, age at diagnosis or a family history of breast cancer in either nulliparous or parous women. CONCLUSIONS: Our findings indicate that induced abortion does not increase breast cancer risk in African-American women.