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Type: Journal article
Title: Greater family size is associated with less cancer risk: an ecological analysis of 178 countries
Author: You, W.
Rühli, F.
Henneberg, R.
Henneberg, M.
Citation: BMC Cancer, 2018; 18(1):924-1-924-14
Publisher: BioMed Central
Issue Date: 2018
ISSN: 1471-2407
Statement of
Wenpeng You, Frank J Rühli, Renata J Henneberg and Maciej Henneberg
Abstract: Background: Greater family size measured with total fertility rate (TFR) and with household size, may offer more life satisfaction to the family members. Positive psychological well-being has been postulated to decrease cancer initiation risk. This ecological study aims to examine the worldwide correlation between family size, used as the measure of positive psychological well-being, and total cancer incidence rates. Methods: Country specific estimates obtained from United Nations agencies on total cancer incidence rates (total, female and male rates in age range 0–49 years and all ages respectively), all ages site cancer incidence (bladder, breast, cervix uteri, colorectum, corpus uteri, lung, ovary and stomach), TFR, household size, life expectancy, urbanization, per capita GDP PPP and self-calculated Biological State Index (Ibs) were matched for data analysis. Pearson’s, non-parametric Spearman’s, partial correlations, independent T-test and multivariate regressions were conducted in SPSS. Results: Worldwide, TFR and household size were significantly and negatively correlated to all the cancer incidence variables. These correlations remained significant in partial correlation analysis when GDP, life expectancy, Ibs and urbanization were controlled for. TFR correlated to male cancer incidence rate (all ages) significantly stronger than it did to female cancer incidence rate (all ages) in both Pearson’s and partial correlations. Multivariate stepwise regression analysis indicated that TFR and household size were consistently significant predictors of all cancer incidence variables. Conclusions: Countries with greater family size have lower cancer risk in both females, and especially males. Our results seem to suggest that it may be worthwhile further examining correlations between family size and cancer risk in males and females through the cohort and case-control studies based on large samples.
Keywords: Total fertility rate; household size; psychological well-being; family life; cancer initiation
Rights: © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
DOI: 10.1186/s12885-018-4837-0
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