Reproductive factors and risk of esophageal squamous cell carcinoma in northern Iran

Abstract

Background Several epidemiologic studies have suggested an inverse association between female reproductive factors and risk of esophageal squamous cell carcinoma (ESCC), but the evidence is not conclusive. We investigated the association of the number of pregnancies, live-births, and miscarriages/stillbirths in women and the association of the number of children in both sexes with ESCC risk in Golestan Province, a high-risk area in Iran. Methods Data from 297 histopathologically confirmed ESCC cases (149 women) and 568 controls (290 women) individually matched to cases for age, sex, and neighborhood of residence were included in this analysis. Conditional logistic regression was used to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Results The average numbers of live-births and miscarriages/stillbirths among controls were 8.2 and 0.8, respectively. Women with 6 or more live-births were at approximately one-third the risk of ESCC as those with 0–3 live-births; the OR (95% CI) for having 6–7 live-births was 0.33 (0.12–0.92). In contrast, the number of miscarriages/stillbirths was associated with an increase in ESCC risk. The OR (95% CI) for ≥ 3 versus no miscarriages/stillbirths was 4.43 (2.11–9.33). The number of children in women was suggestive an inverse association with ESCC, but this association was not statistically significant; in men, no association was seen. Conclusion The findings of this study support a protective influence of female hormonal factors on ESCC risk. However, further epidemiological and mechanistic studies are needed to prove a protective association.

Interaction of Estradiol and Endoplasmic Reticulum Stress in the Development of Esophageal Carcinoma

“…The estrogens-only MHT users had a decreased risk of esophageal and gastric adenocarcinoma in particular ( 8 ). The previous study also supported the protective effects of female hormones on the risk of esophageal squamous cell carcinoma ( 26 ) and esophageal adenocarcinoma ( 27 ). Through several epidemiological studies, the hypothesis of estrogen protection in esophageal cancer has been proposed.…”

Hormonal and reproductive factors and risk of esophageal cancer in women: a meta-analysis

“…After a comprehensive search in databases of PubMed and Embase from their inception up to October 10, 2014, a total of 11 publications were retrieved . Characteristics of all included studies were summarized in Table .…”

“…It has been well established that estrogens confer protective effects on the development of EC . Women using sex hormones, such as HRT after menopause and OC, may be less susceptible to EC.…”

Incidence Trends of Esophageal and Gastric Cancer Subtypes by Race, Ethnicity, and Age in the United States, 1997–2014

“…Some studies have suggested that women may be at a lower risk of esophageal and gastric cancers because of some reproductive or hormonal factors, but these associations need further investigation. [25][26][27] Because of relatively low incidence rates and high cost of endoscopy, screening of the general population for esophageal and gastric cancers in the United states has not been shown to be cost-effective. 28 However, major American gastroenterology organizations have recommended surveillance of high-risk individuals, such as some cases of Barrett's esophagus.…”