title: Reproductive factors and risk of lung cancer in female textile workers in Shanghai, China.
abstract: OBJECTIVE
  Hormonal factors may play a role in the development of lung cancer in women. This study examined the relationship between lung cancer and reproductive factors in a large cohort of women, most of whom never smoked (97%).
  
  
  METHODS
  A cohort of 267,400 female textile workers in Shanghai, China, enrolled in a trial of breast self-examination provided information on reproductive history, demographical factors, and cigarette smoking at enrollment in 1989-91. The cohort was followed until July of 2000 for incidence of lung cancer; 824 cases were identified. Hazard ratios (HR) and 95% confidence intervals (CI) associated with selected reproductive factors were calculated using Cox proportional hazards modeling, adjusting for smoking, age, and also parity when relevant.
  
  
  RESULTS
  Nulliparous women were at increased risk compared to parous women (HR = 1.33, 95% CI 1.00-1.77). Women who had gone through menopause at baseline were at increased risk compared to women of the same age who were still menstruating. Risk was higher in women with a surgical menopause (HR = 1.64, 95% CI 0.96-2.79) than in those with a natural menopause (HR = 1.35, 95% CI 0.84-2.18), and risk was highest in those postmenopausal women with a hysterectomy and bilateral oophorectomy at baseline (HR = 1.39, 95% CI 0.96-2.00), although the risk estimates were not statistically significant.
  
  
  CONCLUSIONS
  These results support experimental data that demonstrate a biological role for hormones in lung carcinogenesis.
authors.affiliation: Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA. lgallag@u.washington.edu
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Gallagher
authors.forename: Karin A
authors.initials: KA
authors.lastname: Rosenblatt
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Ray
authors.forename: Wenjin
authors.initials: W
authors.lastname: Li
authors.forename: Dao L
authors.initials: DL
authors.lastname: Gao
authors.forename: Katie M
authors.initials: KM
authors.lastname: Applebaum
authors.forename: Harvey
authors.initials: H
authors.lastname: Checkoway
authors.forename: David B
authors.initials: DB
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D015331:Cohort Studies; D016001:Confidence Intervals; D004967:Estrogens / Q000502:physiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000503:physiopathology; D008572:Menarche; D008593:Menopause; D008875:Middle Aged; D017698:Postmenopause; D017584:Reproductive History; D018570:Risk Assessment; D012907:Smoking; D013783:Textile Industry
chemical_list: D004967:Estrogens