Reproductive Factors and Risk of Pancreatic Cancer in Women: A Review of the Literature

Wahi, Monika M.; Shah, Nilay; Schrock, Christopher E.; Rosemurgy, Alexander S.; Goldin, Steven B.

doi:10.1016/j.annepidem.2008.11.003

« Previous Next »Annals of Epidemiology
Volume 19, Issue 2 , Pages 103-111, February 2009

Reproductive Factors and Risk of Pancreatic Cancer in Women: A Review of the Literature

Monika M. Wahi, MPH, CPH
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA
- Department of Epidemiology and Biostatistics, University of South Florida College of Public Health, Tampa
- Address correspondence to: Monika M. Wahi, MPH, CPH, United States Army Research Institute of Environmental Medicine, Kansas St., Bldg. 42, Natick, MA 01760-5007. Tel.: (508) 233-5586; fax: (508) 233-4487.
Nilay Shah, MD
- Department of Surgery, University of Pennsylvania School of Medicine, West Philadelphia
Christopher E. Schrock, BS
- Department of Surgery, University of South Florida College of Medicine, Tampa
Alexander S. Rosemurgy II, MD
- Department of Surgery, University of South Florida College of Medicine, Tampa
Steven B. Goldin, MD, PhD
- Department of Surgery, University of South Florida College of Medicine, Tampa

Received 23 August 2008; accepted 19 November 2008.

Purpose

Pancreatic cancer (PCA) is the fourth leading cause of cancer death in the United States. The male-to-female incidence and mortality ratio of PCA is 1.1–2.0. One possible explanation for this difference is that female hormone exposure is protective for the development of PCA. Several hypotheses were investigated in this systematic review: (1) increased exposure to estrogen through early menarche and later menopause is associated with a decreased risk of PCA; (2) increased exposure to pregnancy is associated with decreased risk of PCA; and (3) increased exposure to oral contraceptives and/or hormone replacement therapy is associated with decreased risk of PCA.

Methods

Of 371 articles identified, 10 case-control and 5 cohort studies met the criteria for our review. Odds ratios for case-control studies and hazard ratios for cohort studies and their accompanying 95% confidence intervals for analyses relevant to our hypotheses were considered in the review.

Results

For all 3 hypotheses, studies displayed inconsistent results, and this may have been due to the diversity of study populations, exposure quantification, analysis approach, confounding and other limitations, and biases across studies.

Conclusions

As there was no strong support for any of the 3 hypotheses, it appears that reproductive factors are not associated with the development of PCA in women.

Key Words: Pancreatic neoplasms, Review literature as topic, Reproductive history women, Risk factors

Selected Abbreviations and Acronyms: CI, confidence interval, HR, hazard ratio, HRT, hormone replacement therapy, IGF, insulin-like growth factors, OC, oral contraception, OR, odds ratio, PCA, pancreatic adenocarcinoma