94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Breast Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1541233
Risk Factors for Breast Cancer: An Umbrella Review of Observational Cohort Studies and Causal Relationship Analysis
Provisionally accepted- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To conduct an umbrella review of prospective meta-analyses and perform a causal relationship analysis to evaluate causal effects.Methods: PubMed, Web of Science, Embase, and manual reference list searches were used from database inception to July 27, 2023. Meta-analyses of prospective studies on non-genetic risk factors for breast cancer incidence were included. Overlapping articles were assessed using corrected coverage area. We utilized the AMSTAR-2 criteria to evaluate methodological quality and graded each meta-analysis to assess the strength of evidence. This study is registered with PROSPERO (CRD42023470151). We further explored the causal impacts. Results: Risk factors were classified into 11 categories. Among the 281 meta-analyses of cohort studies, five (1.8%) provided strong evidence, eight (2.8%) indicated highly suggestive evidence, and 23 (8.2%) and 55 (19.6%) showed suggestive and weak evidence, respectively. Breast density (2.89; 2.57-3.25), cardiac glycoside (1.39; 1.33-1.45), atrial fibrillation (1.18; 1.14-1.22), vegetable-fruit-soybean dietary pattern (0.87; 0.83-0.92), and postmenopausal women with BMI ≥25 (0.86; 0.81-0.91) were strongly associated with breast cancer incidence. For all associations graded as weak evidence or higher, further confirmed the causal relationship between BMI, fruit intake, calcium channel blockers, cheese intake, insulin like growth factor-1 levels, serum triglyceride levels causallyDiscussion: Identifying primary risk factors is crucial for delineating high-risk populations among women, facilitating tailored prevention strategies and advancing investigations into underlying mechanisms.
Keywords: breast cancer, etiology, Cohort Studies, Umbrella review, meta-ananlysis
Received: 07 Dec 2024; Accepted: 11 Apr 2025.
Copyright: © 2025 Wang, Feng, Xia, Zhu, Wu and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Song Gao, Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.