Abstract:
The female predominance of gallbladder cancer (GBC) has led to a hypothesis regarding the hormone-related aetiology of GBC. We aimed to investigate the association between female reproductive factors and GBC risk, considering birth cohorts of Asian women. We conducted a pooled analysis of 331,323 women from 12 cohorts across 4 countries (China, Japan, Korea, and Singapore) in the Asia Cohort Consortium. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) to assess the association between reproductive factors (age at menarche, parity, age at first delivery, breastfeeding, and age at menopause) and GBC risk. We observed that a later age at menarche was associated with an increased risk of GBC (HR 1.4, 95% CI 1.16-1.70 for 17 years and older vs. 13-14 years), especially among the cohort born in 1940 and later (HR 2.5, 95% CI 1.50-4.35). Among the cohort born before 1940, women with a later age at first delivery showed an increased risk of GBC (HR 1.56, 95% CI 1.08-2.24 for 31 years of age and older vs. 20 years of age and younger). Other reproductive factors did not show a clear association with GBC risk. Later ages at menarche and at first delivery were associated with a higher risk of GBC, and these associations varied by birth cohort.
摘要:
胆囊癌(GBC)的女性优势导致了关于GBC的激素相关病因的假设。我们的目的是调查女性生殖因素与GBC风险之间的关系。考虑亚洲女性的出生队列。我们对来自4个国家(中国,Japan,韩国,和新加坡)在亚洲队列联盟中。Cox比例风险模型用于估计风险比(HR)和相应的95%置信区间(CI),以评估生殖因素之间的关联(月经初潮时的年龄,奇偶校验,第一次分娩时的年龄,母乳喂养,和绝经年龄)和GBC风险。我们观察到初潮年龄越晚与GBC风险增加相关(17岁及以上的HR1.4,95%CI1.16-1.70与13-14岁),特别是在1940年及以后出生的队列中(HR2.5,95%CI1.50-4.35)。在1940年之前出生的队列中,首次分娩年龄较晚的女性出现GBC的风险增加(31岁及以上的HR1.56,95%CI1.08-2.24与20岁及以下)。其他生殖因素与GBC风险没有明显关联。初潮和首次分娩时年龄较晚,GBC风险较高。这些关联因出生队列而异。