Menstrual and reproductive factors, exogenous hormone use, and gastric cancer risk in a cohort of women from the European Prospective Investigation Into Cancer and Nutrition.
The worldwide incidence of gastric adenocarcinoma (GC) is lower in women than in men. Furthermore, cancer patients treated with estrogens have been reported to have a lower subsequent risk of GC. The authors conducted a prospective analysis of menstrual and reproductive factors, exogenous hormone use, and GC in 335,216 women from the European Prospective Investigation Into Cancer and Nutrition, a cohort study of individuals aged 35-70 years from 10 European countries. After a mean follow-up of 8.7 years (through 2004), 181 women for whom complete exposure data were available developed GC. Adjusted hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards models. All statistical tests were 2-sided. Women who had ovariectomy had a 79% increased risk of GC (based on 25 cases) compared with women who did not (hazard ratio = 1.79, 95% confidence interval: 1.15, 2.78). Total cumulative years of menstrual cycling was inversely associated with GC risk (fifth vs. first quintile: hazard ratio = 0.55, 95% confidence interval: 0.31, 0.98; P(trend) = 0.06). No other reproductive factors analyzed were associated with risk of GC. The results of this analysis provide some support for the hypothesis that endogenous ovarian sex hormones lower GC incidence in women.
Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Avda Gran Via 199-203, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. eduell@iconcologia.net
Eric J
EJ
Duell
Noémie
N
Travier
Leila
L
Lujan-Barroso
M C
MC
Boutron-Ruault
F
F
Clavel-Chapelon
Domenico
D
Palli
Vittorio
V
Krogh
Amalia
A
Mattiello
Rosario
R
Tumino
Carlotta
C
Sacerdote
Laudina
L
Rodriguez
Emilio
E
Sanchez-Cantalejo
Carmen
C
Navarro
Aurelio
A
Barricarte
Miren
M
Dorronsoro
Kay-Tee
KT
Khaw
Nicholas
N
Wareham
Naomi E
NE
Allen
Konstantinos K
KK
Tsilidis
H Bas
HB
Bueno-de-Mesquita
Suzanne M
SM
Jeurnink
M E
ME
Numans
Petra H M
PH
Peeters
Pagona
P
Lagiou
Elisabeth
E
Valanou
Antonia
A
Trichopoulou
Rudolf
R
Kaaks
Annekatrin
A
Lukanova-McGregor
Manuela M
MM
Bergman
Heiner
H
Boeing
Jonas
J
Manjer
Björn
B
Lindkvist
Roger
R
Stenling
Göran
G
Hallmans
Christina C
CC
Dahm
Kim
K
Overvad
Anja
A
Olsen
Anne
A
Tjonneland
Kjersti
K
Bakken
Eiliv
E
Lund
Mazda
M
Jenab
Valerie
V
McCormack
Sabina
S
Rinaldi
Dominique
D
Michaud
Traci
T
Mouw
Gabriella
G
Nesi
Fatima
F
Carneiro
Elio
E
Riboli
Carlos A
CA
González
D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015914:Estrogen Replacement Therapy; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008572:Menarche; D008597:Menstrual Cycle; D008875:Middle Aged; D010052:Ovariectomy; D016016:Proportional Hazards Models; D017584:Reproductive History; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology*