Sex-specific exposure prevalence of established risk factors for oesophageal adenocarcinoma

Rutegård, Martin; Nordenstedt, Helena; Lu, Yunxia; Lagergren, Jesper; Lagergren, Pernilla

doi:10.1038/sj.bjc.6605804

Cited by 28 publications

(26 citation statements)

References 45 publications

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“…Fourteen articles were excluded because of overlap, and 15 articles did not give data on sexspecific prevalence (n = 13) or dealt with single sex population only (n = 2). Fifteen studies were conducted in Asia [2,[29][30][31][32][33][34][35][36][37][38][39][40][41][42], 14 were conducted in Europe [1,10,[43][44][45][46][47][48][49][50][51][52][53][54], and five studies were from the US [55][56][57] and South America [58]. Studies included data on 301 705 patients with significantly more women with 54.5 ± 1.4% (range: 32.1-74.6%; P < 0.001).…”

Section: Sex and Reflux Symptomsmentioning

confidence: 99%

Reflux and sex

Nusrat

Bielefeldt

2012

European Journal of Gastroenterology & Hepatology

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Gastroesophageal reflux (GER) affects ∼10-20% of American adults. Although symptoms are equally common in men and women, we hypothesized that sex influences diagnostic and therapeutic approaches in patients with GER. PubMed database between 1997 and October 2011 was searched for English language studies describing symptoms, consultative visits, endoscopic findings, use and results of ambulatory pH study, and surgical therapy for GER. Using data from Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality, we determined the sex distribution for admissions and reflux surgery between 1997 and 2008. Studies on symptoms or consultative visits did not show sex-specific differences. Even though women are less likely to have esophagitis or Barrett's esophagus, endoscopic studies enrolled as many women as men, and women were more likely to undergo ambulatory pH studies with a female predominance in studies from the US. Surgical GER treatment is more commonly performed in men. However, studies from the US showed an equal sex distribution, with Nationwide Inpatient Sample data demonstrating an increase in women who accounted for 63% of the annual fundoplications in 2008. Despite less common or severe mucosal disease, women are more likely to undergo invasive diagnostic testing. In the US, women are also more likely to undergo antireflux surgery. These results suggest that healthcare-seeking behavior and socioeconomic factors rather than the biology of disease influence the clinical approaches to reflux disease.

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Section: Sex and Reflux Symptomsmentioning

confidence: 99%

Reflux and sex

Nusrat

Bielefeldt

2012

European Journal of Gastroenterology & Hepatology

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“…However, this difference has not been totally attributed to the known risk factors because Barrett's epithelium, low socioeconomic status, and alcohol and tobacco consumption cannot adequately explain this marked sex difference (Chandanos and Lagergren, 2009;Rashid et al, 2010). It has been hypothesized that hormonal factors might play a role in the aetiology of oesophageal cancer (Mao et al, 2011), which has been supported by several basic studies that have shown that oestrogen may have inhibitory effects on the growth of oesophageal cancer cells (Lagergren and Nyrén, 1998;Chandanos and Lagergren, 2009;Rutegård et al, 2010;Yang et al, 2012). Nevertheless, few studies on oesophageal cancer have provided strong enough evidence to support this protective effect.…”

Section: Introductionmentioning

confidence: 94%

Reproductive factors are associated with oesophageal cancer risk: results from a meta-analysis of observational studies

Zhu

Yue

Yuan

et al. 2017

European Journal of Cancer Prevention

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To further evaluate the association between reproductive events and the development of oesophageal cancer, we searched relevant studies using electronic databases (PubMed, ISI Web of Science). Study-specific relative risks with corresponding 95% confidence intervals (CI) in all analyses were used and multiple summary relative risk (SRR) estimates were calculated. We carried out subgroup analyses and used meta-regression techniques to explore potential sources of heterogeneity. Sensitivity analysis was carried out to identify whether pooled results were influenced by individual studies and publication bias was assessed by Begg's funnel plots and the Egger regression asymmetry test. Fourteen studies were eligible for inclusion in the meta-analysis, summarizing a total of 3816 oesophageal cancer cases. We found that age at menopause (SRR=0.70; 95% CI: 0.51-0.95) and hormone replacement therapy (SRR=0.67; 95% CI: 0.56-0.81) had an association with a decreased risk of oesophageal cancer. A similar result was obtained for parity (SRR=0.79; 95% CI: 0.71-0.89) and ever breastfeeding (SRR=0.65; 95% CI: 0.43-0.97). In contrast, postmenopausal status was associated with increased risk (SRR=1.65; 95% CI: 1.28-2.14). No statistically significant link was found with other exposures. Our meta-analysis supports the substantial influence of reproductive factors, which could be causally linked to oesophageal cancer.

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“…Aufgrund der unterschiedlichen Effektstärken dieser Einflussfaktoren auf die Geschlechter und einer eher weiblichen Ausprägung werden diese nicht einheitlich als unabhängige Risikofaktoren bewertet [8,14]. Ein Grund die Risikofaktoren getrennt nach dem Geschlecht zu erfassen (l " Abb.…”

Section: öSophaguskarzinomunclassified

Genderaspekte bei Tumoren des Gastrointestinaltrakts und ihre Prognose, insbesondere im Rahmen multimodaler Therapiekonzepte

et al. 2015

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Systematic analyses of gender effects in gastrointestinal malignancies are currently lacking, partly because sex and gender have not been used as stratification criteria in major studies on the topic. It is, however, indisputable that gastrointestinal tumours differ in risk factors, incidence and prognosis between the genders. This review summarises the most important findings on differences related to biological sex and sociocultural gender and discusses anatomic specifics with immediate significance for surgical interventions. Epidemiological differences in upper gastrointestinal malignancies are most prominent in regard to histological subtypes, directly affecting diagnostics, therapy, and prognosis. Women have a better prognosis in many of these tumour subtypes. For colorectal carcinoma, sex hormones, specifically oestrogens, appear to play a distinct role in tumourigenesis. Histopathological analysis of the expression of oestrogen receptor beta (ERβ) in the tumour tissue has attracted interest since it was shown that women with low ERβ expression have a better prognosis than men with comparable ERβ status. Data on the higher incidence of right-sided colon carcinoma and non-polypoid neoplasms in women could lead to improved screening programmes. Men and women cite differing reasons for avoidance of screening colonoscopies, thus gender specific approaches could improve colon cancer prevention programmes. Data on differing bioavailability of 5-fluorouracil between the genders are useful to minimise adverse effects of chemotherapy and should be accounted for in dosage. Further systematic analysis of gender effects on gastrointestinal tumours is warranted and would be a substantial step towards personalised oncological surgery.

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Sex-specific exposure prevalence of established risk factors for oesophageal adenocarcinoma

Cited by 28 publications

References 45 publications

Reflux and sex

Reflux and sex

Reproductive factors are associated with oesophageal cancer risk: results from a meta-analysis of observational studies

Genderaspekte bei Tumoren des Gastrointestinaltrakts und ihre Prognose, insbesondere im Rahmen multimodaler Therapiekonzepte

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