Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA.
Cancer Causes Control. 2013 Jul;24(7):1305-14. doi: 10.1007/s10552-013-0208-y. Epub 2013 Apr 13.
Hormonal factors may play a role in the development of lung cancer in women. This study examined the relationship between lung cancer and reproductive factors in a large cohort of women, most of whom never smoked (97%).
A cohort of 267,400 female textile workers in Shanghai, China, enrolled in a trial of breast self-examination provided information on reproductive history, demographical factors, and cigarette smoking at enrollment in 1989-91. The cohort was followed until July of 2000 for incidence of lung cancer; 824 cases were identified. Hazard ratios (HR) and 95% confidence intervals (CI) associated with selected reproductive factors were calculated using Cox proportional hazards modeling, adjusting for smoking, age, and also parity when relevant.
Nulliparous women were at increased risk compared to parous women (HR = 1.33, 95% CI 1.00-1.77). Women who had gone through menopause at baseline were at increased risk compared to women of the same age who were still menstruating. Risk was higher in women with a surgical menopause (HR = 1.64, 95% CI 0.96-2.79) than in those with a natural menopause (HR = 1.35, 95% CI 0.84-2.18), and risk was highest in those postmenopausal women with a hysterectomy and bilateral oophorectomy at baseline (HR = 1.39, 95% CI 0.96-2.00), although the risk estimates were not statistically significant.
These results support experimental data that demonstrate a biological role for hormones in lung carcinogenesis.
激素因素可能在女性肺癌的发生发展中起作用。本研究在中国上海的一个大型女性队列中研究了肺癌与生殖因素的关系，该队列中大多数女性（97%）从不吸烟。
上海一个纺织女工队列参与了乳房自我检查试验，该队列在 1989-1991 年入组时提供了生殖史、人口统计学因素和吸烟情况的信息。该队列随访至 2000 年 7 月，以确定肺癌的发病率；共发现 824 例病例。采用 Cox 比例风险模型计算与特定生殖因素相关的风险比（HR）和 95%置信区间（CI），并根据吸烟、年龄和相关的产次进行调整。
与多产妇相比，未产妇的风险增加（HR=1.33，95%CI 1.00-1.77）。基线时已绝经的女性比处于相同年龄仍有月经的女性风险增加。手术绝经的女性风险高于自然绝经的女性（HR=1.64，95%CI 0.96-2.79），且基线时行子宫切除术和双侧卵巢切除术的绝经后女性风险最高（HR=1.39，95%CI 0.96-2.00），尽管风险估计值无统计学意义。
这些结果支持实验数据，表明激素在肺癌发生发展中具有生物学作用。
