Reproductive factors, hormonal interventions, and gastric cancer risk in the Stomach cancer Pooling (StoP) Project.

Monica Ferraroni, M Constanza Camargo, Carlo La Vecchia, Jesus Vioque, Nuno Lunet, Pagona Lagiou, Areti Lagiou, Rashmi Sinha, Mary H Ward, Marcela Guevara, Gemma Castaño-Vinyals, Vicente Martin, Nuria Aragonés, Dmitry Maximovitch, Rossella Bonzi, Linda M Liao, Eva Negri, Domenico Palli, Jinfu Hu, Kenneth C Johnson, Charles S Rabkin, Claudio Pelucchi, Harindra Jayasekara, Minkyo Song, Paolo Boffetta, David Zaridze, Zuo-Feng Zhang, Maria Paula Curado, Gerson Shigueaki Hamada, Akihisa Hidaka, Shoichiro Tsugane

Journal: Cancer causes & control : CCC 2024;35(4):727-737

PMID: 38123742

Abstract

BACKGROUND

Gastric cancer incidence is higher in men, and a protective hormone-related effect in women is postulated. We aimed to investigate and quantify the relationship in the Stomach cancer Pooling (StoP) Project consortium.

METHODS

A total of 2,084 cases and 7,102 controls from 11 studies in seven countries were included. Summary odds ratios (ORs) and 95% confidence intervals (CIs) assessing associations of key reproductive factors and menopausal hormone therapy (MHT) with gastric cancer were estimated by pooling study-specific ORs using random-effects meta-analysis.

RESULTS

A duration of fertility of ≥ 40 years (vs. < 20), was associated with a 25% lower risk of gastric cancer (OR = 0.75; 95% CI: 0.58-0.96). Compared with never use, ever, 5-9 years and ≥ 10 years use of MHT in postmenopausal women, showed ORs of 0.73 (95% CI: 0.58-0.92), 0.53 (95% CI: 0.34-0.84) and 0.71 (95% CI: 0.50-1.00), respectively. The associations were generally similar for anatomical and histologic subtypes.

CONCLUSION

Our results support the hypothesis that reproductive factors and MHT use may lower the risk of gastric cancer in women, regardless of anatomical or histologic subtypes. Given the variation in hormones over the lifespan, studies should address their effects in premenopausal and postmenopausal women. Furthermore, mechanistic studies may inform potential biological processes.

© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

Address: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.; School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.; Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.; School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.; Harbin Medical University, Harbin, China.; Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.; Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia.; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.; Cancer Registration and Surveillance Unit, Public Health Division, Department of Health of Madrid, Madrid, Spain.; Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain.; Barcelona Institute for Global Health-ISGlobal, Barcelona, Spain.; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.; Universitat Pompeu Fabra (UPF), Barcelona, Spain.; Instituto de Salud Pública y Laboral de Navarra, 31003, Pamplona, Spain.; Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain.; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.; Nikkei Disease Prevention Center, São Paulo, Brazil.; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.; Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece.; Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.; Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil.; EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.; Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.; Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain.; Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA. [email protected].

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