Menstrual and reproductive factors and lung cancer risk: A pooled analysis from the international lung cancer consortium
Menstrual and reproductive factors and lung cancer risk: A pooled analysis from the international lung cancer consortium
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DOI：
10.1002/ijc.30750
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发表时间：
2017-07-15
影响因子：
6.4
通讯作者：
Stuker, Isabelle
中科院分区：
文献类型：
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作者：
Ben Khedher, Soumaya;Neri, Monica;Stuker, Isabelle
女性和男性肺癌的许多临床特征是不同的。性类固醇激素在非生殖器官中发挥作用，如肺。月经和生育因素与女性肺癌风险之间的关系仍有争议。我们对国际肺癌联盟的8项研究（4，386例病例和4，177例对照）进行了汇总分析。采用多变量非条件logistic回归分析来评估月经或生殖因素与肺癌之间的关联。对绝经状态、吸烟习惯和组织学进行亚组分析。我们没有发现月经初潮和绝经年龄与肺癌相关的强有力的证据，但绝经后/绝经后妇女与绝经前妇女相比有更高的风险（OR 1.47，95%CI 1.11-1.93）。绝经前女性的风险增加与产次（OR 1.74，95% CI 1.03-2.93）和子女数量（OR 2.88，95% CI 1.21-6.93，超过3个子女;趋势p 0.01）相关，母乳喂养降低（OR 0.54，95% CI 0.30-0.98）。相比之下，绝经后/绝经后受试者在相同暴露量下的OR约为1。吸烟状态或癌症组织学没有产生重大影响。月经和生殖因素可能在肺癌的发生中起作用，但其机制尚不清楚，吸烟仍然是最重要的可改变的危险因素。需要在大型精心设计的研究中进行更多的调查，以证实这些发现，并澄清肺癌风险性别差异的潜在机制。
Many clinical features of lung cancer are different in women and men. Sex steroid hormones exert effects in nonreproductive organs, such as the lungs. The association between menstrual and childbearing factors and the risk of lung cancer among women is still debated. We performed a pooled analysis of eight studies contributing to the International Lung Cancer Consortium (4,386 cases and 4,177 controls). Pooled associations between menstrual or reproductive factors and lung cancer were estimated using multivariable unconditional logistic regression. Subgroup analyses were done for menopause status, smoking habits and histology. We found no strong support for an association of age at menarche and at menopause with lung cancer, but peri/postmenopausal women were at higher risk compared to premenopausal (OR 1.47, 95% CI 1.11-1.93). Premenopausal women showed increased risks associated with parity (OR 1.74, 95% CI 1.03-2.93) and number of children (OR 2.88, 95% CI 1.21-6.93 for more than 3 children; p for trend 0.01) and decreased with breastfeeding (OR 0.54, 95% CI 0.30-0.98). In contrast, peri/postmenopausal subjects had ORs around unity for the same exposures. No major effect modification was exerted by smoking status or cancer histology. Menstrual and reproductive factors may play a role in the genesis of lung cancer, yet the mechanisms are unclear, and smoking remains the most important modifiable risk factor. More investigations in large well-designed studies are needed to confirm these findings and to clarify the underlying mechanisms of gender differences in lung cancer risk.