Association of the Age at Menarche with Site-Specific Cancer Risks in Pooled Data from Nine Cohorts.
Association of the Age at Menarche with Site-Specific Cancer Risks in Pooled Data from Nine Cohorts.
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DOI：
10.1158/0008-5472.can-19-3093
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发表时间：
2021-04-15
期刊：
影响因子：
11.2
通讯作者：
Hoover RN
中科院分区：
文献类型：
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作者：
Fuhrman BJ;Moore SC;Byrne C;Makhoul I;Kitahara CM;Berrington de González A;Linet MS;Weiderpass E;Adami HO;Freedman ND;Liao LM;Matthews CE;Stolzenberg-Solomon RZ;Gaudet MM;Patel AV;Lee IM;Buring JE;Wolk A;Larsson SC;Prizment AE;Robien K;Spriggs M;Check DP;Murphy N;Gunter MJ;Van Dusen HL Jr;Ziegler RG;Hoover RN
在19世纪和20世纪，欧洲和美国人口初潮的平均年龄下降。青春期事件的时间可能对老年妇女的慢性病风险有广泛的影响。我们在1981年至1998年招募的9个美国和欧洲前瞻性队列中，对536,450名女性（中位年龄60岁[范围31-9岁]）的回忆初潮年龄与19种癌症风险的相关性进行了测试。考克斯回归估计了每个队列中初潮年龄与每种癌症风险之间关系的多变量校正风险比（HR）和95%置信区间（CI），并使用随机效应荟萃分析生成每种癌症的汇总估计值。在平均10年的随访中，60，968名女性被诊断出患有首次原发性癌症。在研究的19种癌症中，有7种观察到了逆线性相关。初潮年龄每增加一岁，子宫内膜癌（HR：0.91，CI：0.89-0.94）、肝癌（HR：0.92，CI：0.85-0.99）、黑色素瘤（HR：0.95，CI：0.93-0.98）、膀胱癌（HR：0.96，CI：0.93-0.99）、结肠癌（HR：0.97，CI：0.96-0.99）、肺癌（HR：0.98，CI：0.96 - 0.99）和乳腺癌（HR：0.98，95%CI：0.93-0.99）的风险降低。在校正基线体重指数（BMI）后，除一项外，所有这些相关性均保持统计学显著性。月经初潮和七种癌症之间观察到的关联的相似性表明，共同的潜在原因植根于生命早期。我们提出了一个可验证的假设，即早期暴露于性激素通过改变干细胞在系统能量平衡和组织稳态中的作用来增加中年癌症的风险。
The average age at menarche declined in European and U.S. populations during the 19th and 20th centuries. The timing of pubertal events may have broad implications for chronic disease risks in aging women. Here we tested for associations of recalled menarcheal age with risks of 19 cancers in 536,450 women (median age, 60 years [range, 31-9 years]) in nine prospective US and European cohorts that enrolled participants from 1981 through 1998. Cox regression estimated multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for associations of the age at menarche with risk of each cancer in each cohort and random-effects meta-analysis was used to generate summary estimates for each cancer. Over a median 10 years of follow-up, 60,968 women were diagnosed with a first primary incident cancer. Inverse linear associations were observed for seven of 19 cancers studied. Each additional year in the age at menarche was associated with reduced risks of endometrial cancer (HR:0.91, CI:0.89-0.94), liver cancer (HR:0.92, CI:0.85-0.99), melanoma (HR:0.95, CI:0.93-0.98), bladder cancer (HR:0.96, CI:0.93-0.99), and cancers of the colon (HR:0.97, CI:0.96-0.99), lung (HR:0.98, CI:0.96-0.99), and breast (HR: 0.98, 95% CI:0.93-0.99). All but one of these associations remained statistically significant following adjustment for baseline body mass index (BMI). Similarities in the observed associations between menarche and seven cancers suggest shared underlying causes rooted early in life. We propose as a testable hypothesis that early exposure to sex hormones increases mid-life cancer risks by altering functional capacities of stem cells with roles in systemic energy balance and tissue homeostasis.
影响因子：
8.8
作者：
Gallagher RP;Elwood JM;Hill GB;Coldman AJ;Threlfall WJ;Spinelli JJ
通讯作者：
Spinelli JJ