| Title | Menstrual factors, reproductive history, and risk of lung cancer: a multi-center population-based cohort study in Chinese females |
| Authors | Yang, Zhuoyu Wang, Fei Tan, Fengwei Cao, Wei Xu, Yongjie Qin, Chao Yu, Yiwen Zhao, Liang Wen, Yan Wu, Zheng Zheng, Yadi Liu, Yunyong Yu, Lianzheng Wei, Donghua Dong, Dong Cao, Ji Zhang, Shaokai Yan, Shipeng Wang, Ning Liao, Xianzhen Du, Lingbin Li, Jiang Li, Ni Chen, Wanqing He, Jie |
| Affiliation | Chinese Acad Med Sci & Peking Union Med Coll, Off Canc Screening, Natl Clin Res Ctr Canc, Canc Hosp,Natl Canc Ctr, 17 Panjiayuannanli, Beijing 100021, Peoples R China Chinese Acad Med Sci & Peking Union Med Coll, Dept Thorac Surg, Natl Clin Res Ctr Canc, Canc Hosp,Natl Canc Ctr, 17 Panjiayuannanli, Beijing 100021, Peoples R China China Med Univ, Dept Canc Prevent & Treatment Liaoning Prov, Canc Hosp, Liaoning Canc Hosp & Inst, Shenyang, Peoples R China China Med Univ, Div Pneumoconiosis, Sch Publ Hlth, Shenyang, Peoples R China Liaoning Ctr Dis Control & Prevent, Dept Noncommunicable Chron Dis Prevent, Shenyang, Peoples R China Anhui Prov Canc Hosp, Canc Dept Phys Examinat, Hefei, Peoples R China Xuzhou Canc Hosp, Off Canc Prevent & Treatment, Xuzhou, Jiangsu, Peoples R China Guangxi Med Univ, Dept Expt Pathol, Tumor Hosp, Nanning, Peoples R China Zhengzhou Univ, Henan Engn Res Ctr Canc Prevent & Control, Henan Int Joint Lab Canc Prevent,Henan Engn Res C, Dept Canc Epidemiol,Affiliated Canc Hosp,Henan Ca, Zhengzhou, Henan, Peoples R China Cent South Univ, Hunan Canc Hosp, Dept Canc Prevent & Control, Changsha, Peoples R China Cent South Univ, Affiliated Canc Hosp, Xiangya Sch Med, Changsha, Peoples R China Peking Univ, Key Lab Carcinogenesis & Translat Res, Beijing Off Canc Prevent & Control, Minist Educ Beijing,Canc Hosp & Inst, Beijing, Peoples R China Univ Chinese Acad Sci, Chinese Acad Sci, Dept Canc Prevent, Canc Hosp,Zhejiang Canc Hosp,IBMC, Hangzhou, Peoples R China Chinese Acad Med Sci, Key Lab Natl Canc Big Data Anal & Implement, Beijing, Peoples R China Nanjing Med Univ, Jiangsu Collaborat Innovat Ctr Canc Personalized, Jiangsu Key Lab Canc Biomarkers Prevent & Treatme, Nanjing, Peoples R China |
| Keywords | HORMONAL FACTORS WOMENS-HEALTH ESTROGEN SINGAPORE SMOKING SOY EXPRESSION RECEPTORS SHANGHAI DIET |
| Issue Date | Sep-2021 |
| Publisher | TRANSLATIONAL LUNG CANCER RESEARCH |
| Abstract | Background: Female menstrual and reproductive factors, as remarkable indicators of hormone effect, were hypothesized to be associated with lung cancer risk, whereas the existed epidemiological evidence was inconsistent. Our study aims to investigate the association between menstrual and reproductive factors and lung cancer risk based on the Chinese Lung Cancer Screening Program. Methods: This study was based on a large-scale multi- center population cohort across China recruiting individuals aged 40-74 years old between 2013-2018. Cox regression model was applied to estimate the HRs and 95% CIs. Restricted cubic spline (RCS) analysis was used to estimate dose-response relationships and test for nonlinear associations. Results: Among 553,434 female participants, 1,529 incident lung cancer cases were identified with a median follow-up of 3.61 years. With adjustment for multiple covariates and all significant hormonal factors, elevated lung cancer risk was associated with later age (15, or >= 16 years) at menarche (HR=1.27, 95% CI: 1.04-1.56; HR=1.45, 95% CI: 1.19-1.76), later age (25-29, or >= 30 years) at first live birth (HR=1.27, 95% CI: 1.13-1.43; HR=1.23, 95% CI: 1.00-1.51), and benign breast disease history (HR=1.25, 95% CI: 1.101.41). For postmenopausal females specifically, surgical menopause (HR=1.62; 95% CI: 1.29-2.05) and other surgeries on the reproductive system (HR=1.19; 95% CI: 1.01-1.40) both appeared to be predictive of elevated lung cancer risk. Concerning age at menopause, a nonlinear association was observed (P-nonlinear=0.0126). Increased lung cancer risk was observed among females with age at menopause especially above 50. Although we observed no significant associations between longer time (>= 13 months) of breastfeeding and lung cancer risk among all participants (HR=0.86; 95% CI: 0.71- 1.04), significant decreased adenocarcinoma risk (HR=0.65; 95% CI: 0.53-0.81) was noted among nonsmoking females. Conclusions: Our findings add some support for the role of menstrual and reproductive factors in lung carcinogenesis. However, these relationships were complex, and required further investigations addressing the biological mechanisms. |
| URI | http://hdl.handle.net/20.500.11897/628733 |
| ISSN | 2218-6751 |
| DOI | 10.21037/tlcr-21-552 |
| Indexed | SCI(E) |
| Appears in Collections: | 北京肿瘤医院 |
