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

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.
American journal of epidemiology (Impact Factor: 5.23). 11/2010; 172(12):1384-93. DOI: 10.1093/aje/kwq321
Source: PubMed


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.

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Available from: Leila Lujan-Barroso
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    • "In breast cancer, patients treated with anti-estrogen tamoxifen have been identified to exhibit a significantly increased risk of subsequent gastric cancer (15,16). In addition, ovariectomy also significantly increases the risk of gastric cancer in females (17). Taken together, it has been hypothesized that female sex hormones play a protective role against the development of gastric cancer. "
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    • "Cancers of the upper gastrointestinal tract are associated with significant morbidity and mortality. Cancers of the oesophagus and of the stomach are both more common in men than in women and it has been suggested that this may reflect protection offered by exposure to high levels of oestrogens (Lagergren and Nyrén, 1998; Rutegård et al, 2010a); hence there is interest in the possible role played by hormonal factors, including those related to menarche and menopause and to childbearing, in determining risk for these cancers (Duell et al, 2010; Freedman et al, 2010; Rutegård et al, 2010b; Bodelon et al, 2011). Published evidence suggests that risks for cancers of the oesophagus and stomach are reduced in women taking hormone therapy for the menopause (Green et al, 2011). "
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