Menstrual and Reproductive Factors, Hormone Use, and Risk of Pancreatic Cancer

Luján-Barroso, Leila; Zhang, Wei; Gao, Yu Tang; Yu, Herbert; Baghurst, Peter; Bracci, Paige M.; Bueno-De-Mesquita, H. Bas; Foretová, Lenka; Gallinger, Steven; Holcátová, Ivana; Janout, Vladimí­r; Ji, Bu Tian; Kurtz, Robert C.; Vecchia, Carlo La; Λάγιου, Παγώνα; Li, Donghui; Miller, Anthony B.; Serraino, Diego; Zatoński, Witold; Risch, Harvey A.; Duell, Eric J.

doi:10.1097/mpa.0000000000000635

Cited by 11 publications

(5 citation statements)

References 40 publications

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“…In accordance with most of the current evidence we found no association between hormonal contraception use and pancreatic cancer risk [ 9 – 13 , 17 , 19 , 20 ]( S1 , S2 and S3 Tables). Neither was long-term use associated with risk of pancreas cancer which is in contrast to the suggestion by one previous cohort study [ 3 ].…”

Section: Discussionsupporting

confidence: 91%

Hormonal contraceptive use and risk of pancreatic cancer—A cohort study among premenopausal women

et al. 2018

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ImportanceThe association between the use of hormonal contraceptive and pancreatic cancer among premenopausal women has until now been unclear. This is the first study to investigate the risk of pancreatic cancer in pre-menopausal women.ObjectiveTo determine whether hormonal contraception increases the risk of developing pancreatic cancer in pre-menopausal women.DesignA nationwide prospective cohort study followed all women in Denmark in the age range of 15–49 years without previous cancer or venous thrombosis from 1995 to 2014. The Danish National Prescription Registry provided individually updated exposure information on use of hormonal contraception. The Danish Cancer Registry provided cancer diagnoses, and the Danish National Patient Register containing clinical diagnoses and surgical codes at discharge from public and private hospitals.SettingPopulation-based cohort study.ParticipantsAll women living in Denmark aged 15–49 years at January 1st, 1995, and those subsequently reaching age 15 years up to December 31st, 2014 were eligible for the study.ResultsAmong 1.9 million women who were followed on average for 11.4 years, 235 pancreatic cancers occurred. Compared to never users, ever users of any type of hormonal contraception had a relative risk (RR) of pancreatic cancer of 0.90 (95% confidence interval (CI) 0.68–1.19). No overall association between duration of hormonal contraceptive use and pancreatic cancer risk was found. Neither was long-term use of hormonal contraception associated with pancreas cancer, RR 0.83 (95% CI 0.47–1.50). The risk did not vary between users of combined and progestogen-only products. All models were adjusted for age, completed or ongoing education, polycystic ovary syndrome, endometriosis and among parous women; parity, age at first birth, smoking and body mass index.Conclusions and relevanceCompared to never users the risk of pancreatic cancer is not significantly higher among current and recent users of contemporary hormonal contraception and does not vary between users of combined and progestogen-only products. In conclusion, our study suggests no risk of pancreatic cancer with use of any type of hormonal contraception.

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Section: Discussionsupporting

confidence: 91%

Hormonal contraceptive use and risk of pancreatic cancer—A cohort study among premenopausal women

et al. 2018

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“…Our literature search revealed one previously published meta-analysis that assessed the association between pancreatic cancer risk and female hormonal and menstrual factors[ 12 ], and one pooled analysis from the international pancreatic cancer case-control consortium[ 39 ]. In contrast to our results, a previous meta-analysis found no significant associations between the risk of pancreatic cancer and OC use–pooled RR from six case-control studies and eight cohort studies was 1.09 (95%CI: 0.96-1.23)[ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Association between oral contraceptive use and pancreatic cancer risk: A systematic review and meta-analysis

Ilić¹,

Miličić²,

Ilić³

2021

WJG

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BACKGROUND Studies on the association of oral contraceptive (OC) use and pancreatic cancer showed inconsistent findings. AIM To evaluate the relationship between OC use and pancreatic cancer risk. METHODS A literature search for observational studies (case-control and cohort studies) was conducted up to December 2020. A meta-analysis was performed by calculating pooled relative risks (RRs) and 95% confidence intervals (CIs). Heterogeneity was assessed using Cochran’s chi-square test and I 2 statistic. Subgroup analyses were performed by study design, source of controls in case-control studies, number of cases of pancreatic cancers, study quality according to Newcastle-Ottawa Scale score, geographical region and menopausal status. All analyses were performed using Review Manager 5.3 (RevMan 5.3). RESULTS A total of 21 studies (10 case-control studies and 11 cohort studies) were finally included in the present meta-analysis, comprising 7700 cases of pancreatic cancer in total. A significant association was observed between the ever use of OC and pancreatic cancer risk in the overall analysis (RR = 0.85; 95%CI = 0.73-0.98; P = 0.03). Duration of OC use (< 1 year, < 5 years, 5-10 years, > 10 years) was not significantly associated with the risk of pancreatic cancer. Subgroup analyses revealed a statistically significant subgroup difference for the geographic region in which the study was conducted (Europe vs Americas vs Asia; P = 0.07). Subgroup analyses showed a statistically significant decrease in pancreatic cancer risk and OC use in high-quality studies, studies conducted in Europe, and in postmenopausal women. CONCLUSION Despite the suggested protective effects of OC use in this meta-analysis, further epidemiological studies are warranted to fully elucidate the association between the use of OC and pancreatic cancer risk.

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“… 12 , 27 For MHT use, controversies exist, and inverse relationships between MHT use and pancreatic cancer risk have recently been reported. 8 , 19 , 22 Furthermore, one study has identified increased risk with increasing age at menarche. 8 Likewise, higher age at first birth was identified as a risk factor for pancreatic cancer in a meta-analysis published in 2016, and a more recent cohort study supported this finding.…”

Section: Introductionmentioning

confidence: 99%

“…Studies that have assessed the relationship between pancreatic cancer risk and reproductive factors, such as age at menarche, age at menopause, menopausal status, parity, abortions, age at first birth, breastfeeding, total menstruation duration, and exogenous hormone use, have reported inconsistent results. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] In 2012, a large European cohort study assessed the association between reproductive factors, hormone use, and risk of pancreatic cancer. 21 No significant association was identified.…”

Section: Introductionmentioning

confidence: 99%

Reproductive Factors, Use of Exogenous Hormones, and Pancreatic Cancer Incidence: The Norwegian Women and Cancer Study

Alvarez¹,

Borch²,

Rylander³

2021

CLEP

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Introduction The incidence of pancreatic cancer is increasing worldwide and characterized by a particularly low survival rate. Studies have reported weak and inconsistent evidence for associations among reproductive factors, use of exogenous hormones, and pancreatic cancer incidence in women. Purpose To investigate relationships between reproductive factors, exogenous hormones, and the rate of pancreatic cancer incidence in a large population-based prospective cohort of women in Norway. Methods We used data from the Norwegian Women and Cancer study on 588 incident cases of pancreatic cancer diagnosed among 165,419 women, with mean follow-up of 18.7 years. Cox proportional-hazard models were used to estimate HRs and 95% CIs for associations of interest. Results Cumulative breastfeeding duration >24 months was associated with 63% decreased incidence of pancreatic cancer compared to no breastfeeding. We observed an inverse linear dose–response trend between cumulative breastfeeding duration and pancreatic cancer incidence, which was confirmed in parous women and ever-smokers. Higher age at first birth and menopause were inversely associated with pancreatic cancer incidence, though with less precise effect estimates. Current use of oral contraceptives was associated with a doubling of pancreatic cancer incidence, but the analysis was hampered by a small number of cases. There was no evidence of any associations between age at menarche, parity or use of menopausal hormone therapy, and incidence of pancreatic cancer. Conclusion Our results suggest a potential protective effect of breastfeeding duration against pancreatic cancer incidence. Inconsistent results for the other reproductive factors suggested no important role of estrogens in pancreatic cancer etiology.

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Menstrual and Reproductive Factors, Hormone Use, and Risk of Pancreatic Cancer

Cited by 11 publications

References 40 publications

Hormonal contraceptive use and risk of pancreatic cancer—A cohort study among premenopausal women

Hormonal contraceptive use and risk of pancreatic cancer—A cohort study among premenopausal women

Association between oral contraceptive use and pancreatic cancer risk: A systematic review and meta-analysis

Reproductive Factors, Use of Exogenous Hormones, and Pancreatic Cancer Incidence: The Norwegian Women and Cancer Study

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