Freedman Neal D, Chow Wong-Ho, Gao Yu-Tang, Shu Xiao-Ou, Ji Bu-Tian, Yang Gong, Lubin Jay H, Li Hong-Lan, Rothman Nathaniel, Zheng Wei, Abnet Christian C
Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Gut. 2007 Dec;56(12):1671-7. doi: 10.1136/gut.2007.129411. Epub 2007 Jul 12.
Gastric cancer incidence rates are consistently lower in women than men in both high and low-risk regions worldwide. Sex hormones, such as progesterone and estrogen, may protect women against gastric cancer.
To investigate the association of menstrual and reproductive factors and gastric cancer risk.
These associations were prospectively investigated in 73 442 Shanghai women. After 419 260 person-years of follow-up, 154 women were diagnosed with gastric cancer. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models adjusted for age, body mass index, education, income, and cigarette use.
No associations were observed between gastric cancer risk and age of menarche, number of children, breast feeding, or oral contraceptive use. In contrast, associations were observed with age of menopause (HR 0.80 per five-year increase in menopausal age, 95% CI 0.66-0.97), years of fertility (participants with less than 30 years of fertility were at increased risk compared with those with 30-36 years of fertility, HR 1.90, 95% CI 1.25-2.90), years since menopause (HR 1.26 per five years, 95% CI 1.03-1.53), and intrauterine device use (HR for users 1.61, 95% CI 1.08-2.39).
These results support the hypothesis that female hormones play a protective role in gastric cancer risk.
在全球高风险和低风险地区，胃癌发病率在女性中始终低于男性。孕酮和雌激素等性激素可能保护女性免受胃癌侵害。
调查月经和生殖因素与胃癌风险之间的关联。
对73442名上海女性进行前瞻性调查。经过419260人年的随访，154名女性被诊断为胃癌。使用Cox比例风险模型计算风险比（HR）和95%置信区间（CI），并对年龄、体重指数、教育程度、收入和吸烟情况进行了调整。
未观察到胃癌风险与初潮年龄、子女数量、母乳喂养或口服避孕药使用之间存在关联。相比之下，观察到与绝经年龄（绝经年龄每增加5岁，HR为0.80，95%CI为0.66-0.97）、生育年限（生育年限少于30年的参与者与生育年限为30-36年的参与者相比，风险增加，HR为1.90，95%CI为1.25-2.90）、绝经后年限（每5年HR为1.26，95%CI为1.03-1.53）以及宫内节育器使用（使用者的HR为1.61，95%CI为1.08-2.39）之间存在关联。
这些结果支持女性激素在胃癌风险中起保护作用这一假设。
