International Journal of Epidemiology 2003;32:263-271
© International Epidemiological Association 2003
Special Theme: Cancer |
Hormonal factors and risk of lung cancer among women?
1 Institute of Radiation Hygiene, BfS—Federal Office for Radiation Protection, Neuherberg, Germany.
2 Tumour Centre, University of Regensburg, Regensburg, Germany.
3 Institute of Epidemiology, GSF—National Research Center for Environment and Health, Neuherberg, Germany.
4 Institute of Biometry, Epidemiology and Data Information Processing, School of Veterinary Medicine, University of Hannover, Hannover.
Correspondence: Dr Michaela Kreuzer, BfS-Institute of Radiation Hygiene, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. E-mail: mkreuzer{at}bfs.de
Background Gender differences in the histological distribution of lung carcinoma and a possibly greater susceptibility of women than men to tobacco carcinogens, suggest a possible influence of sex-specific hormones. This study examines endocrine factors and risk of lung cancer among women by smoking status and histology.
Methods We used data of a case-control study on lung cancer conducted from 1990 to 1996 in Germany, including 811 histologically confirmed female cases and 912 female population controls. Information on various menstrual and reproductive factors, use of oral contraceptives (OC), hormone replacement therapy (HRT), and smoking was gathered through personal interviews using a structured questionnaire. Odds ratios (OR) and 95% CI adjusted for age, region, smoking, and education were calculated via logistic regression.
Results A reduction in lung cancer risk was observed with the use of OC (OR = 0.69; 95% CI: 0.51–0.92), but no trend in risk with increasing duration of use, age at first use, or calendar year of first use was present. A history of HRT was associated with a reduced risk (OR = 0.83; 95% CI: 0.64–1.09), particularly after long duration (
7 years) (OR = 0.59; 95% CI: 0.37–0.93). No clear association was found with regard to age at menarche, length of menstrual cycle, number of live-births, and age at menopause. Overall results did not differ much by histological cell subtype. The reduction in lung cancer risk associated with the use of exogenous hormones was primarily seen among smoking women.
Conclusions Our data provide evidence for a possible role of hormonal factors in the aetiology of lung cancer in women.
Keywords Case-control study, hormones, lung cancer, smoking, women
Accepted 14 December 2002
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