Freedman, Neal D. and Lacey, James V. and Hollenbeck, Albert R. and Leitzmann, Michael F. and Schatzkin, Arthur and Abnet, Christian C. (2010) The Association of Menstrual and Reproductive Factors With Upper Gastrointestinal Tract Cancers in the NIH-AARP Cohort. CANCER, 116 (6). pp. 1572-1581. ISSN 0008-543X,
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BACKGROUND: In most populations, incidence rates of upper gastrointestinal (UGI) tract cancers (head and neck, esophagus, and stomach) are higher among men than among women. Established risk factors do not appear to explain these differences, suggesting a possible role for sex hormones. METHODS: 201,506 women of the NIH-AARP Diet and Health cohort completed a questionnaire in 1995-1996. Hazard ratios and 95% confidence intervals were estimated from Cox proportional hazards models. RESULTS: During follow-up through 2003, 162 incident adenocarcinomas (ACs; esophagus, N = 25, and stomach, N = 137) and 353 incident squamous cell carcinomas (SCCs; head and neck, n = 297, and esophagus, N = 56) occurred. Among examined exposures, older age at menopause was associated inversely with SCC (P(trend) across categories = .013) but not AC (P(trend) = .501). Use of menopausal hormone therapy (MHT) was significantly associated with lower risk of SCC (hazard ratio [HR] = 0.77, 0.62-0.96) and nonsignificantly associated with lower risk of AC (HR = 0.81, 0.59-1.12). A subset (N = 127,386) of the cohort completed a more detailed MHT questionnaire a year after baseline. In 74,372 women with intact uteri, ever use of estrogen-progestin MHT conferred 0.47 (0.30-0.75) times the risk for SCC and 0.52 (0.26-1.07) times the risk for ACC. In 51,515 women with a hysterectomy before baseline, we found no associations between use of estrogen MHT and AC or SCC. CONCLUSIONS: Higher estrogen and progesterone levels may be related inversely to UGI cancers and in this way help explain lower incidence rates in women compared with men. Cancer 2010;116:1572-81. (C) 2070 American Cancer Society.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HORMONE-REPLACEMENT THERAPY; CONJUGATED EQUINE ESTROGENS; GASTRIC-CANCER; POSTMENOPAUSAL WOMEN; RISK-FACTORS; NECK-CANCER; NATIONAL-INSTITUTES; ENDOMETRIAL CANCER; COLORECTAL-CANCER; ESOPHAGEAL CANCER; head and neck neoplasms; stomach neoplasms; esophageal neoplasms; estrogen replacement therapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Institut für Epidemiologie und Präventivmedizin > Lehrstuhl für Genetische Epidemiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 03 Aug 2020 11:11 |
| Last Modified: | 03 Aug 2020 11:11 |
| URI: | https://pred.uni-regensburg.de/id/eprint/24974 |
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