title: Reproductive and hormonal factors and the risk of nonsmall cell lung cancer.
abstract: Although exposure to estrogen may directly influence or modify the association between cigarette smoking and lung cancer risk, results from epidemiologic studies examining the association between reproductive and hormonal factors and risk of lung cancer among women have been inconsistent. Between 1998 and 2008, 430 women diagnosed with nonsmall cell lung cancer, 316 hospital controls and 295 population controls were recruited into the multi-center Maryland Lung Cancer Study. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) according to reproductive and hormonal exposures adjusting for age, smoking, passive smoking, education and household income. Results were similar for hospital and population based controls, so the control groups were combined. Reduced risks of lung cancer were observed among women with greater parity (≥ 5 vs. 1-2 births: OR = 0.50, 95% CI = 0.32, 0.78, p-trend = 0.002) and later ages at last birth (≥ 30 vs. <25 years old: OR = 0.68, 95% CI = 0.48, 0.98, p-trend = 0.04). After mutual adjustment parity, but not age at last birth, remained significantly inversely associated with risk (p-trend = 0.01). No associations were found for nonsmall cell lung cancer risk with age at menarche, age at first birth, menopausal status, oral contraceptive use or menopausal hormone use, including use of oral estrogens. Compatible with findings from recent epidemiologic studies, we observed a reduction in the risk of nonsmall cell lung cancer with increasing number of births. Other reproductive and hormonal exposures, including menopausal hormone therapy use, were not associated with risk.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 20852, USA. meinholdc@mail.nih.gov
authors.forename: Cari L
authors.initials: CL
authors.lastname: Meinhold
authors.forename: Amy
authors.initials: A
authors.lastname: Berrington de González
authors.forename: Elise D
authors.initials: ED
authors.lastname: Bowman
authors.forename: Alina V
authors.initials: AV
authors.lastname: Brenner
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Jones
authors.forename: James V
authors.initials: JV
authors.lastname: Lacey
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Loffredo
authors.forename: Donna
authors.initials: D
authors.lastname: Perlmutter
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Schonfeld
authors.forename: Glenwood E
authors.initials: GE
authors.lastname: Trivers
authors.forename: Curtis C
authors.initials: CC
authors.lastname: Harris
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D003276:Contraceptives, Oral; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D010298:Parity; D011379:Prognosis; D017584:Reproductive History; D012307:Risk Factors; D012907:Smoking
chemical_list: D003276:Contraceptives, Oral
references.citation: J Clin Oncol. 2007 Dec 20;25(36):5785-92
references.pmid: 18089876
references.citation: Lung Cancer. 2003 Sep;41(3):283-93
references.pmid: 12928119
references.citation: Cancer Res. 1988 Dec 15;48(24 Pt 1):7279-84
references.pmid: 3191498
references.citation: Br J Cancer. 1990 Dec;62(6):982-7
references.pmid: 2257230
references.citation: Am J Respir Crit Care Med. 2007 Jul 15;176(2):113-20
references.pmid: 17413125
references.citation: Cancer Res. 2002 Apr 1;62(7):2141-50
references.pmid: 11929836
references.citation: Annu Rev Pharmacol Toxicol. 1996;36:203-32
references.pmid: 8725388
references.citation: Epidemiology. 1990 Nov;1(6):474-80
references.pmid: 2090286
references.citation: J Epidemiol. 2003 Jan;13(1):22-8
references.pmid: 12587610
references.citation: Int J Cancer. 2007 May 15;120(10):2214-20
references.pmid: 17278095
references.citation: Pharmacoepidemiol Drug Saf. 2002 Oct-Nov;11(7):561-7
references.pmid: 12462132
references.citation: Lung Cancer. 2002 Aug;37(2):153-9
references.pmid: 12140138
references.citation: Carcinogenesis. 2003 Feb;24(2):269-74
references.pmid: 12584177
references.citation: Cancer Causes Control. 1995 May;6(3):217-24
references.pmid: 7612801
references.citation: Contraception. 2006 Apr;73(4):331-5
references.pmid: 16531161
references.citation: Obstet Gynecol. 1996 Jan;87(1):6-12
references.pmid: 8532268
references.citation: J Natl Cancer Inst. 1994 Jun 1;86(11):869-70
references.pmid: 8182770
references.citation: J Natl Cancer Inst. 2003 Mar 19;95(6):470-8
references.pmid: 12644540
references.citation: Int J Epidemiol. 2003 Apr;32(2):263-71
references.pmid: 12714547
references.citation: Cancer Res. 2005 Oct 15;65(20):9566-73
references.pmid: 16230422
references.citation: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references.pmid: 19474385
references.citation: JAMA. 2002 Jul 17;288(3):321-33
references.pmid: 12117397
references.citation: Int J Cancer. 2005 Nov 20;117(4):662-6
references.pmid: 15929081
references.citation: Clin Pharmacol Ther. 2006 May;79(5):480-8
references.pmid: 16678549
references.citation: Oncology. 1993 Jul-Aug;50(4):285-92
references.pmid: 8388559
references.citation: Cancer Epidemiol Biomarkers Prev. 2009 Mar;18(3):821-7
references.pmid: 19240237
references.citation: Oncology. 2007;73(5-6):305-10
references.pmid: 18493157
references.citation: Cancer Epidemiol Biomarkers Prev. 2008 Mar;17(3):655-60
references.pmid: 18349283
references.citation: Am J Epidemiol. 1993 Sep 1;138(5):281-93
references.pmid: 8395141
references.citation: Clin Cancer Res. 2004 Jan 1;10(1 Pt 1):113-23
references.pmid: 14734459
references.citation: J Natl Cancer Inst. 1996 Feb 21;88(3-4):183-92
references.pmid: 8632492
references.citation: Chest. 2005 Jul;128(1):370-81
references.pmid: 16002959
references.citation: Eur J Epidemiol. 2003;18(12):1109-12
references.pmid: 14758866
references.citation: Ann Intern Med. 1992 Dec 15;117(12):1038-41
references.pmid: 1443972
references.citation: Int J Cancer. 1987 Nov 15;40(5):604-9
references.pmid: 2824385
references.citation: Int J Cancer. 2002 Jan 20;97(3):365-71
references.pmid: 11774290
references.citation: Cancer. 2007 Oct 15;110(8):1768-75
references.pmid: 17879370
references.citation: Lancet Oncol. 2008 Jul;9(7):649-56
references.pmid: 18556244
references.citation: Int J Cancer. 1989 Nov 15;44(5):833-9
references.pmid: 2583865
references.citation: Am J Epidemiol. 2008 Dec 1;168(11):1319-25
references.pmid: 18849300
references.citation: Obstet Gynecol. 2003 Sep;102(3):565-70
references.pmid: 12962944