Reproductive factors and risk of lung cancer in female textile workers in Shanghai, China.
Gallagher-LG; Rosenblatt-KA; Ray-RM; Li-W; Gao-DL; Applebaum-KM; Checkoway-H; Thomas-DB
Cancer Causes Control 2013 Jul; 24(7):1305-1314
PURPOSE: 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%). METHODS: 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. RESULTS: 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. CONCLUSIONS: These results support experimental data that demonstrate a biological role for hormones in lung carcinogenesis.
Cancer; Lung-cancer; Reproductive-system; Humans; Women; Textile-workers; Textiles-industry; Hormones; Hormone-activity; Demographic-characteristics; Risk-analysis; Risk-factors; Carcinogenesis; Physiopathology; Estrogenic-hormones; Age-groups; Epidemiology; Smoking;
Author Keywords: Parity; Reproductive; Cohort; Lung cancer
L. G. Gallagher, Department of Environmental and Occupational Health Sciences, University of Washington, Box 357234, Seattle, WA 98195, USA
Cancer Causes and Control
Boston University Medical Campus