Gynecological and reproductive factors and the risk of pancreatic cancer: A case-control study |
| |
| Institution: | 1. Digestive and Liver Disease Unit, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Milan, Italy;2. Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Hospital, San Raffaele Scientific Institute IRCCS, Milan, Italy;3. Department of Surgery, Umeå University Hospital, Umeå, Sweden;4. Department of Internal Medicine and Medical Specialties, Gastroenterology Unit, Sapienza University of Rome, Milan, Italy;5. Oncology Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Milan, Italy;6. General Surgery and Hepato-pancreato-biliary Unit, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Milan, Italy;7. Department of Surgery, Anschutz Medical Campus, University of Colorado, Denver, USA;1. Department of Hepatopancreatobiliary Surgery, Hangzhou First People’s Hospital, The Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, Zhejiang Province, 310006, China;2. Department of Gastrointestinal Surgery, Hangzhou First People’s Hospital, The Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, Zhejiang Province, 310006, China;1. Department of Radiology and Nuclear Medicine, Martini Hospital Groningen, Van Swietenplein 1, Groningen 9728 NT, The Netherlands;2. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;1. Service de Chirurgie Hépatobiliaire et Digestive, Hôpital Pontchaillou, Centre Hospitalier Universitaire, Université de Rennes 1, Rennes, France;2. Service d''Imagerie Médicale, Hôpital Pontchaillou, Université de Rennes 1, Rennes, France;3. INSERM UMR991, Foie, Métabolismes et Cancer, Université de Rennes 1, Rennes, France;1. Division of Gastroenterology and Hepatology, Mayo Clinic Health System, Eau Claire, WI, USA;2. Division of Gastroenterology, Saint Peter''s University Hospital, New Brunswick, NJ, USA;3. Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA;4. Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA;5. Center for Pancreatic Care, Division of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA;6. Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, USA;7. Division of Gastroenterology and Hepatology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA |
| |
| Abstract: | Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) has a higher incidence in men compared to women, although the difference in known risk factors cannot explain this disparity completely. Reproductive and hormonal factors have been demonstrated in pre-clinical studies to influence pancreatic carcinogenesis, but the few published data on the topic are inconsistent. The aim was to investigate the role of reproductive and hormonal factors on PDAC occurrence in women.MethodsWe conducted a unicenter case-control study; PDAC cases were matched to controls by age with a 1:2 ratio. Risk factors were screened through questionnaires about gynecologic and medical history. Comparisons were made using Chi-square and Fisher’s exact tests where appropriate for categorical variables and Student’s t-test for continuous variables. Logistic regression was used to calculate Odds Ratios (ORs) and their 95% confidence intervals (CI). Multivariable logistic regression models were adjusted for potential confounders.Results253 PDAC and 506 matched controls were enrolled. At logistic regression multivariable analysis adjusted for confounding factors, older age at menopause (OR:0.95 per year; 95% CI:0.91–0.98; p = 0.007), use of Oral Contraceptives (OR:0.52; 95% CI:0.30–0.89; p = 0.018), use of Hormonal Replacement Therapy (OR:0.31; 95% CI:0.15–0.64; p = 0.001), and having had two children (OR:0.57; 95% CI:0.38–0.84; p = 0.005) were significant, independent protective factors for the onset of PDAC.ConclusionsThese data confirm some previous findings on menopause age and number of births while, to our knowledge, this is the first study to show a protective effect of HRT and OC use. The results collectively support the hypothesis that exposure to estrogens plays a protective role towards PDAC. |
| |
| Keywords: | Pancreatic cancer Oral contraceptive Hormonal replacement therapy Gynecological factors Parity |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
