Reproductive Factors, Exogenous Hormones, and Pancreatic Cancer Risk in the CTS
Reproductive Factors, Exogenous Hormones, and Pancreatic Cancer Risk in the CTS
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DOI：
10.1093/aje/kwt154
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发表时间：
2013-11-01
影响因子：
5
通讯作者：
Bernstein, Leslie
中科院分区：
文献类型：
--
作者：
Lee, Eunjung;Horn-Ross, Pamela L.;Bernstein, Leslie
女性类固醇激素被假设在胰腺癌风险中起保护作用。然而，流行病学研究的结果，检查与吸烟有关的暴露一直不一致。加州教师研究是1995 - 1996年对公立学校女性专业人员进行的队列研究。在118，164名合格的研究参与者中，截至2009年12月31日，有323名女性被诊断为侵袭性胰腺癌。多变量考克斯比例风险回归方法被用来估计胰腺癌风险与生殖因素和外源性激素使用的相关性的风险比和95个置信区间。目前仅使用雌激素治疗的基线（1995 - 1996年）胰腺癌的风险低于从未使用激素治疗的参与者（风险比0.59，95置信区间：0.42，0.84）。使用雌激素加孕酮治疗与胰腺癌的风险无关。口服避孕药使用时间较长（使用10年与从未使用相比）与癌症风险增加相关（风险比1.72，95置信区间：1.19，2.49）。生殖因素，包括初潮年龄、产次、母乳喂养和绝经年龄，与胰腺癌风险无关。我们的研究结果表明，增加雌激素暴露通过雌激素治疗可能会降低胰腺癌的风险。
Female steroid hormones are hypothesized to play a protective role in pancreatic cancer risk. However, results from epidemiologic studies that examined hormone-related exposures have been inconsistent. The California Teachers Study is a cohort study of female public school professionals that was established in 19951996. Of the 118,164 eligible study participants, 323 women were diagnosed with incident invasive pancreatic cancer through December 31, 2009. Multivariable Cox proportional hazards regression methods were used to estimate hazard ratios and 95 confidence intervals for the association of pancreatic cancer risk with reproductive factors and exogenous hormone use. Current users of estrogen-only therapy at baseline (19951996) had a lower risk of pancreatic cancer than did participants who had never used hormone therapy (hazard ratio 0.59, 95 confidence interval: 0.42, 0.84). Use of estrogen-plus-progestin therapy was not associated with the risk of pancreatic cancer. A longer duration of oral contraceptive use (10 years of use compared with never use) was associated with an increased risk of cancer (hazard ratio 1.72, 95 confidence interval: 1.19, 2.49). Reproductive factors, including age at menarche, parity, breastfeeding, and age at menopause, were not associated with pancreatic cancer risk. Our results suggest that increased estrogen exposure through estrogen-only therapy may reduce pancreatic cancer risk in women.