Kabat Geoffrey C, Kamensky Victor, Rohan Thomas E
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, United States.
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, United States.
Cancer Epidemiol. 2017 Aug;49:1-7. doi: 10.1016/j.canep.2017.05.002. Epub 2017 May 15.
The epidemiologic literature on menstrual and reproductive factors associated with pancreatic cancer has yielded weak and inconsistent evidence of an association. Furthermore, few cohort studies have examined the association of exogenous hormone use, including type and duration, with this disease. The aim of this study was to assess the association of these exposures with risk of pancreatic cancer in a large cohort of postmenopausal women.
We used data from the Women's Health Initiative on 1003 cases of pancreatic cancer diagnosed among 158,298 participants over 14.3 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the associations of interest.
Being parous vs. nulliparous was associated with reduced risk (HR=0.84, 95% CI 0.70-1.00), and women who had 1-2 and 3-4 births were at decreased risk compared to nulliparous women, whereas women who had >5 births showed no decrease in risk. Compared to women who gave birth between the ages of 20-29, women who gave birth at age 30 or above were at increased risk (HR 1.23, 95% CI 1.00-1.53, p for trend 0.003). Other reproductive factors and exogenous hormone use were not associated with risk.
Together with the existing literature on this topic, our results suggest that reproductive and hormonal exposures are unlikely to play an important role in the etiology of pancreatic cancer.
关于与胰腺癌相关的月经和生殖因素的流行病学文献所提供的关联证据薄弱且不一致。此外，很少有队列研究考察外源性激素使用（包括类型和持续时间）与该疾病的关联。本研究的目的是评估在一大群绝经后女性中，这些暴露因素与胰腺癌风险之间的关联。
我们使用了女性健康倡议的数据，该数据来自158,298名参与者，在14.3年的随访期间有1003例胰腺癌确诊病例。采用Cox比例风险模型来估计感兴趣的关联的风险比（HR）和95%置信区间（95%CI）。
经产妇与未产妇相比，风险降低（HR = 0.84，95%CI 0.70 - 1.00），与未产妇相比，生育过1 - 2次和3 - 4次的女性风险降低，而生育超过5次的女性风险没有降低。与在20 - 29岁之间生育的女性相比，30岁及以上生育的女性风险增加（HR 1.23，95%CI 1.00 - 1.53，趋势检验p值为0.003）。其他生殖因素和外源性激素使用与风险无关。
结合关于该主题的现有文献，我们的结果表明生殖和激素暴露在胰腺癌病因中不太可能起重要作用。
