Menstrual factors, reproductive history, and risk of lung cancer: a multi-center population-based cohort study in Chinese females

doi:10.21037/tlcr-21-552

	Menstrual factors, reproductive history, and risk of lung cancer: a multi-center population-based cohort study in Chinese females
	Yang, Zhuoyu 6; Wang, Fei 6; Tan, Fengwei 5; Cao, Wei 6; Xu, Yongjie 6; Qin, Chao 6; Yu, Yiwen 6; Zhao, Liang 6; Wen, Yan 6; Wu, Zheng 6
刊名	TRANSLATIONAL LUNG CANCER RESEARCH
	2021-10-01
卷号	10
关键词	Lung cancer hormones population-based cohort study
ISSN号	2218-6751
DOI	10.21037/tlcr-21-552
通讯作者	Li, Ni(nli@cicams.ac.cn) ; He, Jie(prof.jiehe@gmail.com)
英文摘要	Background: Female menstrual and reproductive factors, as remarkable indicators of hormone effect, were hypothesized to be associated with lung cancer risk, whereas the existed epidemiological evidence was inconsistent. Our study aims to investigate the association between menstrual and reproductive factors and lung cancer risk based on the Chinese Lung Cancer Screening Program. Methods: This study was based on a large-scale multi- center population cohort across China recruiting individuals aged 40-74 years old between 2013-2018. Cox regression model was applied to estimate the HRs and 95% CIs. Restricted cubic spline (RCS) analysis was used to estimate dose-response relationships and test for nonlinear associations. Results: Among 553,434 female participants, 1,529 incident lung cancer cases were identified with a median follow-up of 3.61 years. With adjustment for multiple covariates and all significant hormonal factors, elevated lung cancer risk was associated with later age (15, or >= 16 years) at menarche (HR=1.27, 95% CI: 1.04-1.56; HR=1.45, 95% CI: 1.19-1.76), later age (25-29, or >= 30 years) at first live birth (HR=1.27, 95% CI: 1.13-1.43; HR=1.23, 95% CI: 1.00-1.51), and benign breast disease history (HR=1.25, 95% CI: 1.101.41). For postmenopausal females specifically, surgical menopause (HR=1.62; 95% CI: 1.29-2.05) and other surgeries on the reproductive system (HR=1.19; 95% CI: 1.01-1.40) both appeared to be predictive of elevated lung cancer risk. Concerning age at menopause, a nonlinear association was observed (P-nonlinear=0.0126). Increased lung cancer risk was observed among females with age at menopause especially above 50. Although we observed no significant associations between longer time (>= 13 months) of breastfeeding and lung cancer risk among all participants (HR=0.86; 95% CI: 0.71- 1.04), significant decreased adenocarcinoma risk (HR=0.65; 95% CI: 0.53-0.81) was noted among nonsmoking females. Conclusions: Our findings add some support for the role of menstrual and reproductive factors in lung carcinogenesis. However, these relationships were complex, and required further investigations addressing the biological mechanisms.
资助项目	Ministry of Finance of the People's Republic of China ; National Health Commission of the People's Republic of China ; National Key Research & Development Program of China[2018YFC1315000/2018YFC1315001] ; Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences[2019PT320027] ; Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences[2020PT330001] ; CAMS Innovation Fund for Medical Science[2019-I2M-2-002] ; Sanming Project of Medicine in Shenzhen[SZSM201911015] ; National Natural Science Foundation of China[8187102812] ; Beijing Science and Technology Project[Z181100001718212] ; Medical Sciences and Peking Union Medical College[IRB:15-070/997]
WOS关键词	HORMONAL FACTORS ; WOMENS-HEALTH ; ESTROGEN ; SINGAPORE ; SMOKING ; SOY ; EXPRESSION ; RECEPTORS ; SHANGHAI ; DIET
WOS研究方向	Oncology ; Respiratory System
语种	英语
出版者	AME PUBL CO
WOS记录号	WOS:000710739500001
资助机构	Ministry of Finance of the People's Republic of China ; National Health Commission of the People's Republic of China ; National Key Research & Development Program of China ; Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences ; CAMS Innovation Fund for Medical Science ; Sanming Project of Medicine in Shenzhen ; National Natural Science Foundation of China ; Beijing Science and Technology Project ; Medical Sciences and Peking Union Medical College
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/126702]
专题	中国科学院合肥物质科学研究院
通讯作者	Li, Ni; He, Jie
作者单位	1.Anhui Prov Canc Hosp, Canc Dept Phys Examinat, Hefei, Peoples R China 2.Liaoning Ctr Dis Control & Prevent, Dept Noncommunicable Chron Dis Prevent, Shenyang, Peoples R China 3.China Med Univ, Div Pneumoconiosis, Sch Publ Hlth, Shenyang, Peoples R China 4.China Med Univ, Dept Canc Prevent & Treatment Liaoning Prov, Canc Hosp, Liaoning Canc Hosp & Inst, Shenyang, Peoples R China 5.Chinese Acad Med Sci & Peking Union Med Coll, Dept Thorac Surg, Natl Clin Res Ctr Canc, Canc Hosp,Natl Canc Ctr, 17 Panjiayuannanli, Beijing 100021, Peoples R China 6.Chinese Acad Med Sci & Peking Union Med Coll, Off Canc Screening, Natl Clin Res Ctr Canc, Canc Hosp,Natl Canc Ctr, 17 Panjiayuannanli, Beijing 100021, Peoples R China 7.Chinese Acad Med Sci, Key Lab Natl Canc Big Data Anal & Implement, Beijing, Peoples R China 8.Xuzhou Canc Hosp, Off Canc Prevent & Treatment, Xuzhou, Jiangsu, Peoples R China 9.Guangxi Med Univ, Dept Expt Pathol, Tumor Hosp, Nanning, Peoples R China 10.Zhengzhou Univ, Henan Engn Res Ctr Canc Prevent & Control, Henan Int Joint Lab Canc Prevent,Henan Engn Res C, Dept Canc Epidemiol,Affiliated Canc Hosp,Henan Ca, Zhengzhou, Henan, Peoples R China
推荐引用方式 GB/T 7714	Yang, Zhuoyu,Wang, Fei,Tan, Fengwei,et al. Menstrual factors, reproductive history, and risk of lung cancer: a multi-center population-based cohort study in Chinese females[J]. TRANSLATIONAL LUNG CANCER RESEARCH,2021,10.
APA	Yang, Zhuoyu.,Wang, Fei.,Tan, Fengwei.,Cao, Wei.,Xu, Yongjie.,...&He, Jie.(2021).Menstrual factors, reproductive history, and risk of lung cancer: a multi-center population-based cohort study in Chinese females.TRANSLATIONAL LUNG CANCER RESEARCH,10.
MLA	Yang, Zhuoyu,et al."Menstrual factors, reproductive history, and risk of lung cancer: a multi-center population-based cohort study in Chinese females".TRANSLATIONAL LUNG CANCER RESEARCH 10(2021).