Menstrual and reproductive risk factors and risk for gastric adenocarcinoma in women: findings from the canadian national enhanced cancer surveillance system

Abstract

Purpose: The role of menstrual and reproductive risk factors for gastric cancer has not been well studied.

Methods: This population-based case-control study included 326 women aged 20 to 74 years with gastric adenocarcinoma. Controls were 326 women frequency matched on age. Data for reproductive and/or hormonal exposure and gastric cancer risk factors were captured through self-administered questionnaire.

Results: Later age at menarche was associated with increased risk for adenocarcinoma compared with menarche onset at younger than 13 years of age (13 to 14 years: odds ratio [OR], 1.45; 95% confidence interval [CI], 1.00-2.10; > or =15 years: OR, 1.93; 95% CI, 1.19-3.13). Compared with premenopause, natural menopause was associated with increased risk for adenocarcinoma (OR, 1.99; 95% CI, 0.98-4.05). Compared with nulliparity, 4 or more births were associated with decreased risk for gastric cancer, as was being pregnant for 5 months or longer if the first pregnancy occurred at younger than 24 years (OR, 0.55; 95% CI, 0.31-0.96) or 25 years or older (OR, 0.67; 95% CI, 0.38-1.18). Oral contraceptives and hormone replacement therapy were associated with a non-statistically significant decreased risk.

Conclusion: These findings suggest that hormonal factors associated with greater exposure to estrogen and/or progesterone may be associated with decreased risk for gastric cancer.