title: Menstrual and reproductive factors and the mortality risk of gastric cancer in Japanese menopausal females.
abstract: OBJECTIVE
  The relationship between gastric cancer and menstrual and reproductive history was investigated for 40,535 postmenopausal females from a large-scale prospective cohort in Japan (JACC: Japan Collaborative Cohort Study for Evaluation of Cancer Risk, sponsored by Monbusho).
  
  
  METHODS
  A Cox proportional hazard model was used to estimate risk with respect to menstrual and reproductive factors for gastric cancer mortality. The effects on risk of potential confounders such as lifestyle, dietary habits, and socioeconomic status were controlled for using a stepwise procedure.
  
  
  RESULTS
  During the study period (mean 8.2 years), 156 deaths due to gastric cancer were identified. Longer fertility tended to be inversely associated with risk of gastric cancer mortality, although the association was not significant. Late menopause had no obvious effect on gastric cancer risk. The risk ratio of delivery experience compared to no delivery was 0.62 (95% confidence interval 0.27-1.41), and this effect was consistent regardless of the number of deliveries. Early menarche was not associated with the risk of gastric cancer. The potential confounders were not seen to have distinct effects on the associations.
  
  
  CONCLUSIONS
  Multiparity appears to confer a protective tendency on gastric cancer mortality; however, this result is inconsistent with previous reports. Further information needs to be accumulated from epidemiological studies in order to clarify the role of reproductive factors in gastric cancer.
authors.affiliation: Department of Clinical Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan. stkaneko@ncc.go.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kaneko
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ohno
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.forename: Takesumi
authors.initials: T
authors.lastname: Yoshimura
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D008593:Menopause; D008598:Menstruation; D008875:Middle Aged; D011446:Prospective Studies; D012098:Reproduction; D017584:Reproductive History; D012307:Risk Factors; D012923:Social Class; D013274:Stomach Neoplasms / Q000209:etiology / Q000401:mortality*