title: Menstrual factors, reproductive factors and lung cancer risk: a meta-analysis.
abstract: OBJECTIVE
  Epidemiological studies have suggested that menstrual and reproductive factors may influence lung cancer risk, but the results are controversial. We therefore carried out a meta-analysis aiming to examine the associations of lung cancer in women with menstrual and reproductive factors.
  
  
  METHODS
  Relevant studies were searched from PubMed database, CNKI, WANFANG DATA and VIP INFORMATION up to January 2012, with no language restrictions. References listed from selected papers were also reviewed. We included studies that reported the estimates of relative risks (RRs) with 95% confidence intervals (CIs) for the association between menstrual and reproductive factors and lung cancer risk. The pooled RRs were calculated after the heterogeneity test with the software Stata 11, and publication bias and sensitivity were evaluated at the same time.
  
  
  RESULTS
  Twenty-five articles, representing 24 independent studies, were included in this meta-analysis. Older age at menarche in North America women (RR=0.83; 95%CI: 0.73-0.94) was associated with a significant decreased risk of lung cancer. Longer length of menstrual cycle was also associated with decreased lung cancer risk (RR=0.72; 95%CI: 0.57-0.90). Other exposures were not significantly associated.
  
  
  CONCLUSIONS
  Our analysis provides evidence of the hypothesis that female sex hormones influence the risk of lung cancer in women, yet additional studies are warranted to extend this finding and to clarify the underlying mechanisms.
authors.affiliation: Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110001, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Yin
authors.forename: Li
authors.initials: L
authors.lastname: Shen
authors.forename: Yan
authors.initials: Y
authors.lastname: Wan
authors.forename: Baosen
authors.initials: B
authors.lastname: Zhou
mesh_terms: D000367:Age Factors; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008572:Menarche; D008597:Menstrual Cycle; D008598:Menstruation; D009656:North America / Q000453:epidemiology; D017584:Reproductive History; D012307:Risk Factors; D013997:Time Factors