Sex differences in the incidence of gastrointestinal adenocarcinoma in Sweden 1970–2006

Rutegård, Martin; Shore, Richard; Lu, Yunxia; Lagergren, Pernilla; Lindblad, Mats

doi:10.1016/j.ejca.2010.01.029

Cited by 52 publications

(46 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This oestrogen hypothesis is supported by a 20-year delay in the onset of OAC in women compared to men, 9 and a particularly high male-to-female ratio during women's reproductive years. 10 Individual investigations of the potential role of exogenous hormonal therapy in women, including hormone replacement therapy (HRT) and oral contraceptives (OC), in the aetiology of OAC have failed to provide conclusive results. [11][12][13][14][15] The low incidence of OAC in women has hampered the statistical precision in the available studies.…”

mentioning

confidence: 99%

Hormone Replacement Therapy and Oral Contraceptives and Risk of Oesophageal Adenocarcinoma: A Systematic Review and Meta-analysis.

Lagergren

Brusselaers

2015

International Journal of Epidemiology

View full text Add to dashboard Cite

There is an unexplained strong male predominance in the aetiology of oesophageal adenocarcinoma (OAC). The hypothesis that oestrogens are protective, deserves attention. A potential protective influence of exogenous oestrogen exposure, that is, hormone replacement therapy (HRT) and oral contraceptives (OC) has been addressed only in studies of limited statistical power, and the individual studies have not provided conclusive results. We conducted a systematic literature search and meta-analysis on HRT and OC and the risk of OAC. We used the databases PubMed and the Web of Science. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by the Mantel-Haenszel random-effect method. A total of five studies were included. Compared to never users, ever users of HRT had a statistically significantly decreased risk of OAC (pooled OR 5 0.75; 95% CI: 0.58-0.98), and ever users of OC had a borderline significantly decreased risk of this cancer (pooled OR 5 0.76; 95% CI: 0.57-1.00). In conclusion, HRT and OC use seems to be associated with a decreased risk of OAC. However, further research is warranted.Oesophageal adenocarcinoma (OAC) is up to nine times more common in men than women, yet the reasons behind this pattern remain unclear. 1,2 Gastro-oesophageal reflux and high body mass index (BMI), the two main risk factors for OAC, seem to influence the risk of developing OAC similarly in both genders, and might not explain the male predominance. [3][4][5][6] The typical male fat distribution, with mainly abdominal adiposity, is a stronger risk factor for OAC than BMI alone, 7 but it is uncertain if this exposure contributes the sex ratio of OAC. 8 It has also been hypothesised that female sex hormones, mainly oestrogen, are protective. This oestrogen hypothesis is supported by a 20-year delay in the onset of OAC in women compared to men, 9 and a particularly high male-to-female ratio during women's reproductive years. 10 Individual investigations of the potential role of exogenous hormonal therapy in women, including hormone replacement therapy (HRT) and oral contraceptives (OC), in the aetiology of OAC have failed to provide conclusive results. 11-15 The low incidence of OAC in women has hampered the statistical precision in the available studies. HRT is used to mitigate discomfort caused by decreased levels of circulating oestrogen and progesterone after menopause. Combined HRT includes both oestrogens and progesterone, and is recommended to women with an intact uterus, as it counteracts endometrial hyperplasia associated with oestrogen therapy. Oestrogen only HRT is recommended to women who have undergone hysterectomy. 16,17 The most commonly used OCs contain both oestrogen and progesterone. The often called 'mini pill' contains progesterone only, 18 and is recommended during breastfeeding as oestrogen reduces the amount of breast milk. 19 With the purpose of improving the knowledge of the relationship between HRT and OC exposure and risk of OAC, we conducted a systematic review and meta-analysis. Material a...

show abstract

mentioning

confidence: 99%

Hormone Replacement Therapy and Oral Contraceptives and Risk of Oesophageal Adenocarcinoma: A Systematic Review and Meta-analysis.

Lagergren

Brusselaers

2015

International Journal of Epidemiology

View full text Add to dashboard Cite

show abstract

“…1 The male-tofemale ratio seems to be age dependent with the highest ratio in those below 50 years of age and the lowest in those above 80 years of age. 2 …”

Section: To the Editormentioning

confidence: 99%

Expression of Androgen Receptors in Barrett Esophagus

Nordenstedt

Younes

El–Serag

2012

Journal of Clinical Gastroenterology

View full text Add to dashboard Cite

“…In Schweden und in den Niederlanden weist das Kardiakarzinom einen leichten Rückgang bzw. eine stabile Erkrankungssituation auf [29,32,33]. Im Allgemeinen zeigt sich jedoch, dass es einen signifikant deutlicheren Rückgang der Inzidenz von distaler gelegenen Magenkarzinomen («NichtKardiakarzinomen») gibt [16,25,29,31,34].…”

Section: Epidemiologische Trends Für Adenokarzinome Des öSophagogastrunclassified

Das Karzinom am ösophagogastralen Übergang: Epidemiologische Trends und Risikofaktoren

Bornschein¹,

Selgrad²,

Malfertheiner³

2012

Viszeralmedizin

View full text Add to dashboard Cite

In den letzten Jahrzehnten kam es zu einer deutlichen Zunahme von Adenokarzinomen am ösophagogastralen Übergang. Plattenepithelkarzinome des Ösophagus und distale Magenkarzinome zeigten dagegen eine rückläufige Tendenz. Hierbei bestehen allerdings erhebliche regionale Unterschiede. Die Bewertung dieses Sachverhalts ist dadurch erschwert, dass in den meisten Studien keine einheitliche Klassifikation von Tumoren des ösophagogastralen Übergangs angewendet wurde. Auch in der Analyse beteiligter Risikofaktoren ist man daher auf die Auswertung von Daten zu Kardiakarzinomen und ösophagealen Adenokarzinomen angewiesen. Adenokarzinome des ösophagogastralen Übergangs setzen sich aus zwei Entitäten zusammen: Tumoren mit ösophagealem und solche mit gastralem Ursprung. Während für ösophageale Karzinome ein klarer Zusammenhang mit der Refluxerkrankung, insbesondere mit dem Vorliegen eines Barrett-Ösophagus sowie mit einer Adipositas, gezeigt wurde, sind gastrale Adenokarzinome vor allem mit der Helicobacter-pylori-Infektion assoziiert. Tabakrauchen hat einen negativen Einfluss auf beide Entitäten, während Alkoholkonsum keinen Risikofaktor darstellt. Eine erhöhte Zufuhr von Fleisch, insbesondere rotem Fleisch und Fleischprodukten, ist mit einem erhöhten Risiko vergesellschaftet, während eine gemüse- und früchtereiche Diät eher einen protektiven Effekt hat. Die Einnahme von ASS und nichtsteroidalen Antirheumatika (NSAR) kann sich ebenfalls protektiv auswirken, wird jedoch aufgrund der damit verbundenen gastrointestinalen Nebenwirkungen nicht empfohlen. In prospektiven Studien ist nun insbeson die Definition geeigneter Surrogatparameter gefragt, mit deren Hilfe Adenokarzinome am ösophagogastralen Übergang besser differenziert werden können, um entsprechende Präventionsstrategien zu entwickeln.

show abstract

Sex differences in the incidence of gastrointestinal adenocarcinoma in Sweden 1970–2006

Cited by 52 publications

References 40 publications

Hormone Replacement Therapy and Oral Contraceptives and Risk of Oesophageal Adenocarcinoma: A Systematic Review and Meta-analysis.

Hormone Replacement Therapy and Oral Contraceptives and Risk of Oesophageal Adenocarcinoma: A Systematic Review and Meta-analysis.

Expression of Androgen Receptors in Barrett Esophagus

Das Karzinom am ösophagogastralen Übergang: Epidemiologische Trends und Risikofaktoren

Contact Info

Product

Resources

About