Sarah S Jackson1, Hans-Olov Adami2, Gabriella Andreotti3, Laura E Beane-Freeman3, Amy Berrington de González3, Julie E Buring4, Gary E Fraser5, Neal D Freedman3, Susan M Gapstur6, Gretchen Gierach3, Graham G Giles7, Francine Grodstein8, Patricia Hartge3, Mazda Jenab9, Victoria Kirsh10, Synnove F Knutsen5, Qing Lan3, Susanna C Larsson11, I-Min Lee4, Mei-Hsuan Lee12, Linda M Liao3, Roger L Milne7, Kristine R Monroe13, Marian L Neuhouser14, Katie M O'Brien15, Jessica L Petrick16, Mark P Purdue3, Thomas E Rohan17, Sven Sandin2, Dale P Sandler15, Norie Sawada18, Aladdin H Shadyab19, Tracey G Simon20, Rashmi Sinha3, Rachael Stolzenberg-Solomon3, Shoichiro Tsugane18, Elisabete Weiderpass21, Alicja Wolk11, Hwai-I Yang22, Wei Zheng23, Katherine A McGlynn3, Peter T Campbell6, Jill Koshiol3. 1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA. Electronic address: sarah.jackson@nih.gov. 2. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA. 4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. 5. School of Public Health, Loma Linda University, Loma Linda, CA, USA. 6. Behavioral and Epidemiology Research Group, American Cancer Society, Inc., Atlanta, GA, USA. 7. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia. 8. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 9. Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France. 10. Ontario Institute for Cancer Research, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 11. Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. 12. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. 13. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 14. Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 15. Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA. 16. Slone Epidemiology Center, Boston University, Boston, MA, USA. 17. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA. 18. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. 19. Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA. 20. Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical, Boston, MA, USA. 21. International Agency for Research on Cancer (IARC), Lyon, France. 22. Genomics Research Center, Academia Sinica, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. 23. Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA.
Abstract
BACKGROUND & AIMS: Gallbladder cancer (GBC) is known to have a female predominance while other biliary tract cancers (BTCs) have a male predominance. However, the role of female reproductive factors in BTC etiology remains unclear. METHODS: We pooled data from 19 studies of >1.5 million women participating in the Biliary Tract Cancers Pooling Project to examine the associations of parity, age at menarche, reproductive years, and age at menopause with BTC. Associations for age at menarche and reproductive years with BTC were analyzed separately for Asian and non-Asian women. Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models, stratified by study. RESULTS: During 21,681,798 person-years of follow-up, 875 cases of GBC, 379 of intrahepatic bile duct cancer (IHBDC), 450 of extrahepatic bile duct cancer (EHBDC), and 261 of ampulla of Vater cancer (AVC) occurred. High parity was associated with risk of GBC (HR ≥5 vs. 0 births 1.72; 95% CI 1.25-2.38). Age at menarche (HR per year increase 1.15; 95% CI 1.06-1.24) was associated with GBC risk in Asian women while reproductive years were associated with GBC risk (HR per 5 years 1.13; 95% CI 1.04-1.22) in non-Asian women. Later age at menarche was associated with IHBDC (HR 1.19; 95% CI 1.09-1.31) and EHBDC (HR 1.11; 95% CI 1.01-1.22) in Asian women only. CONCLUSION: We observed an increased risk of GBC with increasing parity. Among Asian women, older age at menarche was associated with increased risk for GBC, IHBDC, and EHBDC, while increasing reproductive years was associated with GBC in non-Asian women. These results suggest that sex hormones have distinct effects on cancers across the biliary tract that vary by geography. LAY SUMMARY: Our findings show that the risk of gallbladder cancer is increased among women who have given birth (especially women with 5 or more children). In women from Asian countries, later age at menarche increases the risk of gallbladder cancer, intrahepatic bile duct cancer and extrahepatic bile duct cancer. We did not see this same association in women from Western countries. Age at menopause was not associated with the risk of any biliary tract cancers. Published by Elsevier B.V.
BACKGROUND & AIMS:Gallbladder cancer (GBC) is known to have a female predominance while other biliary tract cancers (BTCs) have a male predominance. However, the role of female reproductive factors in BTC etiology remains unclear. METHODS: We pooled data from 19 studies of >1.5 million women participating in the Biliary Tract Cancers Pooling Project to examine the associations of parity, age at menarche, reproductive years, and age at menopause with BTC. Associations for age at menarche and reproductive years with BTC were analyzed separately for Asian and non-Asian women. Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models, stratified by study. RESULTS: During 21,681,798 person-years of follow-up, 875 cases of GBC, 379 of intrahepatic bile duct cancer (IHBDC), 450 of extrahepatic bile duct cancer (EHBDC), and 261 of ampulla of Vater cancer (AVC) occurred. High parity was associated with risk of GBC (HR ≥5 vs. 0 births 1.72; 95% CI 1.25-2.38). Age at menarche (HR per year increase 1.15; 95% CI 1.06-1.24) was associated with GBC risk in Asian women while reproductive years were associated with GBC risk (HR per 5 years 1.13; 95% CI 1.04-1.22) in non-Asian women. Later age at menarche was associated with IHBDC (HR 1.19; 95% CI 1.09-1.31) and EHBDC (HR 1.11; 95% CI 1.01-1.22) in Asian women only. CONCLUSION: We observed an increased risk of GBC with increasing parity. Among Asian women, older age at menarche was associated with increased risk for GBC, IHBDC, and EHBDC, while increasing reproductive years was associated with GBC in non-Asian women. These results suggest that sex hormones have distinct effects on cancers across the biliary tract that vary by geography. LAY SUMMARY: Our findings show that the risk of gallbladder cancer is increased among women who have given birth (especially women with 5 or more children). In women from Asian countries, later age at menarche increases the risk of gallbladder cancer, intrahepatic bile duct cancer and extrahepatic bile duct cancer. We did not see this same association in women from Western countries. Age at menopause was not associated with the risk of any biliary tract cancers. Published by Elsevier B.V.
Authors: Aladdin H Shadyab; Caroline A Macera; Richard A Shaffer; Sonia Jain; Linda C Gallo; Margery L S Gass; Molly E Waring; Marcia L Stefanick; Andrea Z LaCroix Journal: Menopause Date: 2017-01 Impact factor: 2.953
Authors: Jill Koshiol; Vanessa Van De Wyngard; Emma E McGee; Paz Cook; Ruth M Pfeiffer; Noldy Mardones; Karie Medina; Vanessa Olivo; Karen Pettit; Sarah S Jackson; Fabio Paredes; Raúl Sanchez; Andrea Huidobro; Miguel Villaseca; Enrique Bellolio; Hector Losada; Juan Carlos Roa; Allan Hildesheim; Juan Carlos Araya; Catterina Ferreccio Journal: Am J Epidemiol Date: 2021-02-01 Impact factor: 4.897
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