Teng Yvonne, Saito Eiko, Abe Sarah K, Sawada Norie, Iwasaki Motoki, Yamaji Taiki, Shimazu Taichi, Sasazuki Shizuka, Inoue Manami, Tsugane Shoichiro
aDepartment of Global Health Policy bAXA Department of Health and Human Security, Graduate School of Medicine, The University of Tokyo cEpidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
Eur J Cancer Prev. 2017 Sep;26(5):378-384. doi: 10.1097/CEJ.0000000000000358.
An association between female reproductive factors, exogenous hormone use, and pancreatic cancer risk has long been suggested in laboratory settings, but epidemiological findings remain mixed and inconclusive. Studies carried out on Asian populations are also limited. In this study, 45 617 women aged 40-69 years were followed for an average of 18.4 years in the Japan Public Health Center-based prospective cohort and 211 pancreatic cases were identified as of 31 December 2011. We applied multivariate-adjusted Cox proportional hazards regression models using age as a time-scale to assess the association between female reproductive factors (menstrual status, menarche age, menopause age, number of births, age at first birth, total years of fertility, history of breastfeeding) and exogenous hormone use with the incidence of pancreatic cancer through hazard ratios and confidence intervals. No significant associations were found between our examined female reproductive factors and pancreatic cancer incidence. The use of exogenous hormones was found to be associated with an increased risk of pancreatic cancer in a multivariate-adjusted model (hazard ratio: 1.47; 95%; confidence interval: 1.00-2.14) in the Japanese female population. Our results suggest that exogenous hormones may play a role in the formation of pancreatic cancer, and further prospective studies are warranted for clarification.
长期以来，实验室研究表明女性生殖因素、外源性激素使用与胰腺癌风险之间存在关联，但流行病学研究结果仍不一致且尚无定论。针对亚洲人群的研究也较为有限。在本研究中，对日本公共卫生中心前瞻性队列中45617名年龄在40 - 69岁的女性进行了平均18.4年的随访，截至2011年12月31日共确诊211例胰腺癌病例。我们使用年龄作为时间尺度，应用多变量调整的Cox比例风险回归模型，通过风险比和置信区间评估女性生殖因素（月经状况、初潮年龄、绝经年龄、生育次数、首次生育年龄、总生育年限、母乳喂养史）和外源性激素使用与胰腺癌发病率之间的关联。在我们所研究的女性生殖因素与胰腺癌发病率之间未发现显著关联。在多变量调整模型中，发现日本女性人群使用外源性激素与胰腺癌风险增加相关（风险比：1.47；95%置信区间：1.00 - 2.14）。我们的研究结果表明，外源性激素可能在胰腺癌形成中起作用，有必要进行进一步的前瞻性研究以明确。
