Reproductive Factors and Risk of Pancreatic Cancer in Women: A Review of the Literature

Wahi, Monika M.; Shah, Nilay; Schrock, Christopher; Rosemurgy, Alexander S.; Goldin, Steven B.

doi:10.1016/j.annepidem.2008.11.003

Cited by 41 publications

(34 citation statements)

References 49 publications

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“…Risk factors that are not modifiable include age, gender, diabetes mellitus, family history of pancreatic cancer and chronic pancreatitis. [15][16][17][18][19][20][21] Generally, the characteristics of our patients were mostly similar to that reported in the literature. The mean age of our patients was 61.24 years, which is similar to that observed in other studies.…”

Section: Discussionsupporting

confidence: 76%

Pancreatic ductal adenocarcinoma in a Moroccan population: analysis of six years experience

et al. 2018

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Background: Few studies have been done to investigate pancreatic cancer in Morocco. Therefore, the aim of our study was to describe the epidemiological, clinical and therapeutic features of pancreatic ductal adenocarcinoma in Moroccan population.Methods: Author retrospectively reviewed the medical data of pancreatic ductal adenocarcinoma patients presented to the Medical Oncology Department of the Military Hospital Moulay Ismail in Meknes, Morocco, from January 2011 to December 2016.Results: The study included 67 cases of pancreatic ductal adenocarcinoma. The mean age of patients was 61.24±10.35 years. Male/female ratio was 3.2/1. 20.9% of patients were cigarette smokers, 10.5% alcoholics. 23.9% diabetics, 3.0% with a positive family history of pancreatic cancer and 25.4% with a family history of diabetes mellitus. The main symptoms for consultation were weight loss (68.6%), abdominal pain (64.2%), jaundice (53.7%) and vomiting (25.4%). The tumour was located to the pancreatic head in 71.6% of cases. Stage IV disease was the most common stage representing 47.8% of patients. Biliary and duodenal stent placements were respectively performed in 10.4% and 3.0% of patients. 23.9% of patients underwent curative surgery, 7.5% had palliative surgery and 86.6% received chemotherapy. The median overall survival for the entire cohort was 9.3 months (95% CI 7.2-12.1 months) with a median follow-up of 9.7 months (2-63 months).Conclusions: The data on pancreatic ductal adenocarcinoma in Moroccan population are similar to the epidemiologic literature data. With multimodality treatments, the results in terms of survival benefit seem to be similar to those in Asian and Caucasian populations.

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Section: Discussionsupporting

confidence: 76%

Pancreatic ductal adenocarcinoma in a Moroccan population: analysis of six years experience

et al. 2018

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“…Motivated by these observations, and under the hypothesis that greater exposure to female sex hormones (through early menarche, later menopause, high number of pregnancies, and having a history of hormone use) decreases the risk of PC, several epidemiological studies have examined possible risk associations with menstrual and reproductive factors, and hormone use, but with inconsistent results. A review paper on reproductive factors and PC 13 , two meta-analyses on parity 14,15 , and a recent meta-analysis 16 attempted to make clear the relations between these factors and PC risk. Comparing and summarizing previous evidence, however, is not a simple task.…”

Section: Introductionmentioning

confidence: 99%

Menstrual and Reproductive Factors, Hormone Use, and Risk of Pancreatic Cancer

et al. 2016

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Objectives We aimed to evaluate the relation between menstrual and reproductive factors, exogenous hormones, and risk of pancreatic cancer (PC). Methods Eleven case-control studies within the International Pancreatic Cancer Case-Control Consortium (PanC4) took part in the present study, including in total 2,838 case and 4,748 control women. Pooled estimates of odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using a two-step logistic regression model and adjusting for relevant covariates. Results An inverse OR was observed in women who reported having had hysterectomy (ORyesvs.no 0.78, 95%CI 0.67–0.91), remaining significant in post-menopausal women and never-smoking women, adjusted for potential PC confounders. A mutually-adjusted model with the joint effect for hormone replace therapy (HRT) and hysterectomy showed significant inverse associations with PC in women who reported having had hysterectomy with HRT use (OR 0.64, 95%CI 0.48–0.84). Conclusion Our large pooled analysis suggests that women who have had a hysterectomy may have reduced risk of PC. However, we cannot rule out that the reduced risk could be due to factors or indications for having had a hysterectomy. Further investigation of risk according to HRT use and reason for hysterectomy may be necessary.

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“…Though a previous review has focused on this topic [33], to our knowledge, a comprehensive and quantitative assessment of the association between parity and PC risk has not been conducted. Therefore, we carried out a dose-response meta-analysis on epidemiologic studies published up to November 2013 to quantify the association between parity and PC.…”

Section: Introductionmentioning

confidence: 99%

Parity and Pancreatic Cancer Risk: A Dose-Response Meta-Analysis of Epidemiologic Studies

Guan

et al. 2014

PLoS ONE

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BackgroundPrevious epidemiologic studies have reported inconsistent results between parity and pancreatic cancer (PC) risk. To our knowledge, a comprehensive and quantitative assessment of this association has not been conducted.MethodsRelevant published studies of parity and PC were identified using MEDLINE (PubMed) and Web of Science databases until November 2013. Two authors (H-BG and LW) independently assessed eligibility and extracted data. Eleven prospective and 11 case-control studies reported relative risk (RR) estimates and 95% confidence intervals (CIs) of PC associated with parity. Fixed- and random-effects models were used to estimate the summary RR depending on the heterogeneity of effects.ResultsThe summary RR for PC comparing the highest versus lowest parity was 0.86 (95% CI: 0.73–1.02; Q = 50.49, P<0.001, I 2 = 58.4%). Significant inverse associations were also observed in the studies that adjusted for cigarette smoking (RR = 0.81; 95% CI: 0.68–0.98), Type 2 diabetes mellitus (RR = 0.83; 95% CI: 0.75–0.93), and those that included all confounders or important risk factors (RR = 0.85; 95% CI: 0.76–0.96). Additionally, in the dose-response analysis, the summary RR for per one live birth was 0.97 (95% CI: 0.94–1.01; Q = 62.83, P<0.001, I 2 = 69.8%), which also indicated a borderline statistically significant inverse effect of parity on PC risk. No evidence of publication bias and significant heterogeneity between subgroups were detected by meta-regression analyses.ConclusionIn summary, these findings suggest that higher parity is associated with a decreased risk of PC. Future large consortia or pooled studies are warranted to fully adjust for potential confounders to confirm this association.

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Reproductive Factors and Risk of Pancreatic Cancer in Women: A Review of the Literature

Cited by 41 publications

References 49 publications

Pancreatic ductal adenocarcinoma in a Moroccan population: analysis of six years experience

Pancreatic ductal adenocarcinoma in a Moroccan population: analysis of six years experience

Menstrual and Reproductive Factors, Hormone Use, and Risk of Pancreatic Cancer

Parity and Pancreatic Cancer Risk: A Dose-Response Meta-Analysis of Epidemiologic Studies

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