Breast cancer determinants in low- to upper-middle-income countries: an umbrella review of meta-analyses of observational studies and an urgent call for implementation science

Abstract

This umbrella review identified eight key breast cancer risk factors. Non-modifiable factors like age ≥ 40 and family history, along with modifiable factors such as overweight, smoking, oral contraceptive use, air pollution, and night shift work, increased the odds of breast cancer. Adequate fruit and vegetable intake was linked to reduced odds, suggesting a protective effect. We recommend that public health strategies promote healthy lifestyles and target high-risk groups through early screening and awareness campaigns, using evidence-based interventions to reduce the breast cancer burden.