Relation Between Smoking and Age of Natural Menopause

Jick, Hershel; Porter, Jane; Morrison, A. I.

doi:10.1016/s0140-6736(77)92562-4

Cited by 323 publications

(56 citation statements)

References 6 publications

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“…We have been unable to explain the association in terms of any known confounding variable. It is, of course, established that, on average, cigarette smokers have an earlier age of natural menopause than non-smokers (Jick et al, 1977) and, as a consequence, post-menopausal smokers would be expected to be at slightly lower risk of breast cancer than non-smokers. The association that we have observed cannot, however, be explained in terms of this mechanism.…”

Section: Discussionmentioning

confidence: 99%

Oral contraceptives and breast cancer: Final report of an epidemiological study

Vessey¹,

Baron

Doll³

et al. 1983

Br J Cancer

160

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Summary During [1968][1969][1970][1971][1972][1973][1974][1975][1976][1977][1978][1979][1980], 1176 women aged 16-50 years with newly diagnosed breast cancer and a like number of matched controls were interviewed at 9 teaching hospitals in London and Oxford and asked about their use of oral contraceptives. The results were reassuring. A few statistically significant differences in oral contraceptive use were found between the breast cancer and control groups, but the data were subdivided in many ways so that some "significant" differences would have been expected through the play of chance alone. Certainly no patterns of risk emerged which would suggest that any of the associations were causal. It must be stressed, however, that the data are still sparse in some importanr subcategories-for example, only small numbers of both cases and controls had prolonged oral contraceptive use before their first term pregnancy. For this reason, it is important that information on the possible relationship between pill use and breast cancer should continue to be collected. Women who had never used oral contraceptives presented with appreciably more advanced tumours than those who had been using oral contraceptives during the year before detection of cancer, while past users were in an intermediate position. These differences in staging were reflected in the pattern of survival. Possible explanations for these observations include "surveillance bias" among oral contraceptive users leading to earlier diagnosis and a beneficial biological effect of oral contraceptives on tumour growth and spread. Women with breast cancer reported never having used any method of contraception and heavy cigarette smoking (> 15 per day) significantly less often than controls. We could find no obvious explanation for the former observation, but suspect that the latter reflects the unrepresentative smoking habits of our hospital controls rather than a protective effect of smoking against breast cancer.

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Section: Discussionmentioning

confidence: 99%

Oral contraceptives and breast cancer: Final report of an epidemiological study

Vessey¹,

Baron

Doll³

et al. 1983

Br J Cancer

160

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“…Smokers are lean (Wack & Rodin, 1982), have an early menopause (Jick et al, 1977), and have reduced levels of circulating oestrogens due to an increased hepatic turnover (Daniel et al, 1992). All these factors contribute to a reduced exposure to estrogen, resulting in an increased early bone loss.…”

Section: Introductionmentioning

confidence: 99%

The influence of smoking on vitamin D status and calcium metabolism

1999

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Objective: To assess the in¯uence of smoking on serum parathyroid hormone (PTH), serum vitamin D metabolites, serum ionized calcium, serum phosphate, and biochemical markers of bone turnover in a cohort of 510 healthy Danish perimenopausal women. Design: A cross-sectional study. Setting: Copenhagen, Denmark. Subjects: Five-hundred-and-ten healthy women aged 45 ± 58 y, included 3 ± 24 months after last menstrual bleeding. None were using hormone replacement therapy. Methods: The women were grouped according to their current smoking status. The two groups were compared with regard to serum levels of 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D (1,25-(OH) 2 D), intact PTH, ionized calcium and phosphate, osteocalcin, as well as urine pyridinolines. Bone mineral density (BMD) was measured with DEXA-scans. Multiple regression analyses were performed to detect the effect of potentially confounding lifestyle factors, such as calcium and vitamin D intakes, alcohol and coffee consumption, sunbathing, and physical exercise. Results: Fifty percent were current smokers. Smokers had signi®cantly reduced levels of serum 25OHD (P 0.02), 1,25(OH) 2 D (P 0.001), and PTH (P`0.001). There was no difference in serum ionized calcium between smokers and non-smokers. We found a negative effect of smoking on serum osteocalcin (P 0.01), while urinary pyridinolines were similar in the two groups. The small differences in lifestyle between the two groups could not explain these ®ndings. Smokers had small but signi®cant reductions in bone mineral density. Conclusions: Smoking has a signi®cant effect on calcium and vitamin D metabolism, which is not likely to be explained by other confounding lifestyle factors. The depression of the vitamin D-PTH system seen among smokers may represent another potential mechanism for the deleterious effects of smoking on the skeleton, and may contribute to the reported risk of osteoporosis among smokers.

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“…Jick (10) and Lindquist (9) also found an association between smoking and premature menopause. By inducing a premature menopause, smoking may also elevate the serum cholesterol level and thus further increase the risk of ischaemic heart disease.…”

Section: Discussionmentioning

confidence: 96%