Menstrual Factors, Reproductive History, Hormone Use, and Urothelial Carcinoma Risk: A Prospective Study in the EPIC Cohort
Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Urothelial carcinoma is the predominant (95%) bladder cancer subtype in industrialized nations. Animal and epidemiologic human studies suggest that hormonal factors may influence urothelial carcinoma risk. METHODS: We used an analytic cohort of 333,919 women from the European Prospective Investigation into Cancer and Nutrition Cohort. Associations between hormonal factors and incident urothelial carcinoma (overall and by tumor grade, tumor aggressiveness, and non-muscle-invasive urothelial carcinoma) risk were evaluated using Cox proportional hazards models. RESULTS: in parous women = 0.010) and MHT use (compared with nonuse) was positively associated with urothelial carcinoma risk (HR = 1.27; 1.03-1.57), but no dose response by years of MHT use was observed. No modification of HRs by smoking status was observed. Finally, sensitivity analyses in never smokers showed similar HR patterns for the number of FTP, while no association between MHT use and urothelial carcinoma risk was observed. Association between MHT use and urothelial carcinoma risk remained significant only in current smokers. No heterogeneity of the risk estimations in the final model was observed by tumor aggressiveness or by tumor grade. A positive association between MTH use and non-muscle-invasive urothelial carcinoma risk was observed. CONCLUSIONS: Our results support that increasing the number of FTP may reduce urothelial carcinoma risk. IMPACT: More detailed studies on parity are needed to understand the possible effects of perinatal hormone changes in urothelial cells.
Authors: Leila Lujan-Barroso, Edoardo Botteri, Saverio Caini, Börje Ljungberg, Nina Roswall, Anne Tjønneland, Bas Bueno-de-Mesquita, Inger T. Gram, Rosario Tumino, Lambertus A. Kiemeney, Fredrik Liedberg, Tanja Stocks, Marc J. Gunter, Neil Murphy, Iris Cervenka, Agnès Fournier, Marina Kvaskoff, Christel Häggström, Kim Overvad, Eiliv Lund, Marit Waaseth, Renée Turzanski Fortner, Tilman Kühn, Virginia Menéndez, Maria-Jose Sánchez, Carmen Santiuste, Aurora Perez-Cornago, Raul Zamora-Ros, Amanda J. Cross, Antonia Trichopoulou, Anna Karakatsani, Eleni Peppa, Domenico Palli, Vittorio Krogh, Veronica Sciannameo, Amalia Mattiello, Salvatore Panico, Carla H. van Gils, N. Charlotte Onland-Moret, Aurelio Barricarte, Pilar Amiano, Kay-Tee Khaw, Heiner Boeing, Elisabete Weiderpass, Eric J. Duell
Institutions: Institut d'Investigació Biomédica de Bellvitge, Institut Català d'Oncologia, Universitat de Barcelona, Oslo University Hospital, Cancer Registry of Norway, Umeå University, Danish Cancer Society, University of Copenhagen, University Medical Center Utrecht, University of Malaya, National Institute for Public Health and the Environment, Imperial College London, UiT The Arctic University of Norway, Radboud University Nijmegen, Radboud University Medical Center, Radboud Institute for Health Sciences, Lund University, Skåne University Hospital, World Health Organization, Centre international de recherche sur le cancer, Inserm, Institut Gustave Roussy, Centre de recherche en Epidémiologie et Santé des Populations, Uppsala University, Uppsala University Hospital, Aarhus University, German Cancer Research Center, Gobierno del Principado de Asturias, Universidad de Granada, Instituto de Investigación Biosanitaria de Granada, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Andalusian School of Public Health, Instituto Murciano de Investigación Biosanitaria, University of Oxford, Hellenic Health Foundation, National and Kapodistrian University of Athens, University General Hospital Attikon, Fondazione IRCCS Istituto Nazionale dei Tumori, Federico II University Hospital, University of Naples Federico II, Utrecht University, Instituto de Salud Pública de Navarra, Navarre Institute of Health Research, Basque Government, Biogipuzkoa Health Research Institute, University of Cambridge, Addenbrooke's Hospital, German Institute of Human Nutrition
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: World Health Organization, Kræftens Bekæmpelse, Deutsches Krebsforschungszentrum, Centres de Recerca de Catalunya, Cancer Research UK, European Commission, Institut National de la Santé et de la Recherche Médicale, ZonMw, Bundesministerium für Bildung und Forschung, Cancerfonden, Generalitat de Catalunya, Ligue Contre le Cancer, Vetenskapsrådet, KWF Kankerbestrijding, Associazione Italiana per la Ricerca sul Cancro, Deutsche Krebshilfe, Istituto Nanoscienze, Consiglio Nazionale delle Ricerche, Institut Gustave-Roussy, Mutuelle Générale de l'Education Nationale, Hellenic Health Foundation, Medical Research Council, World Cancer Research Fund, Instituto de Salud Carlos III, European Social Fund
Awards: G1055973116, G1075502044, G1192877484, G1265254713, G1344656563, G172151099, G1767199718, G1788645866, G1993546569, G2131326840, G2149865848, G219746026, G2216207056, G2235605558, G2257231888, G2372467518, G2409987178, G2539064604, G2572521044, G273148272, G2742323354, G2841678936, G2871896171, G29072894, G3010599472, G3027676146, G3049845011, G3077395769, G3189789075, G3216658785, G3452641779, G3544161537, G3675143906, G3747421453, G375319704, G382879149, G3980646122, G4041385912, G4049848471, G4081633361, G4089957676, G4213141252, G4303038735, G43956866, G4473162978, Health of vegetarians, G459595259, G4682079261, G4811780622, G4879533352, G490534113, G5004963360, G5406065712, G558017500, G5706284561, G5897142711, G5990830295, G6085534252, G6442500046, G6820515600, G7025202487, G7040807446, G7306252069, G7426181285, G7447125227, G7600088736, G7624991799, G7646326732, G7939399614, G8050896463, G8057573662, G817390530, G8279237360, G8407261631, G8508326818, G8525262851, G8869854444, G8959392569, G8978728421
OpenAlex ID: W3032834241