Sex hormones, hormonal interventions, and gastric cancer risk: a meta-analysis

Cancer Epidemiol Biomarkers Prev. 2012 Jan;21(1):20-38. doi: 10.1158/1055-9965.EPI-11-0834. Epub 2011 Oct 25.

Abstract

Estrogens may influence gastric cancer risk, but published studies are inconclusive. We therefore carried out a meta-analysis addressing the associations of gastric cancer in women with menstrual and reproductive factors and with use of estrogen- and antiestrogen-related therapies. Searches of PubMed up to June, 2011 and review of citations yielded a total of 28 independent studies, including at least one exposure of interest. Random effects pooled estimates of relative risk (RR) and corresponding 95% CIs were calculated for eight exposures reported in at least five studies, including: age at menarche, age at menopause, years of fertility, parity, age at first birth, oral contraceptive use, hormone replacement therapy (HRT), and tamoxifen treatment. Longer years of fertility (RR = 0.74, 95% CI: 0.63-0.86) and HRT (RR = 0.77; 95% CI: 0.64-0.92) were each associated with decreased gastric cancer risk. Conversely, tamoxifen treatment was associated with increased risk (RR = 1.82; 95% CI: 1.39-2.38). The other five exposures were not significantly associated. Our analysis supports the hypothesis that longer exposure to estrogen effects of either ovarian or exogenous origin may decrease risk of gastric cancer. Additional studies are warranted to extend this finding and to identify the underlying mechanisms.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Estrogen Replacement Therapy / adverse effects
  • Estrogen Replacement Therapy / statistics & numerical data*
  • Female
  • Gonadal Steroid Hormones / administration & dosage*
  • Gonadal Steroid Hormones / adverse effects
  • Humans
  • Reproductive History
  • Risk Factors
  • Stomach Neoplasms / epidemiology*
  • Stomach Neoplasms / etiology

Substances

  • Gonadal Steroid Hormones