Menstrual and Reproductive Factors, Exogenous Hormone Use, and Gastric Cancer Risk in a Cohort of Women From the European Prospective Investigation Into Cancer and Nutrition

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The worldwide incidence of gastric adenocarcinoma (GC) is lower in women than in men. Furthermore, cancer patients treated with estrogens have been reported to have a lower subsequent risk of GC. The authors conducted a prospective analysis of menstrual and reproductive factors, exogenous hormone use, and GC in 335,216 women from the European Prospective Investigation Into Cancer and Nutrition, a cohort study of individuals aged 35-70 years from 10 European countries. After a mean follow-up of 8.7 years (through 2004), 181 women for whom complete exposure data were available developed GC. Adjusted hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards models. All statistical tests were 2-sided. Women who had ovariectomy had a 79% increased risk of GC (based on 25 cases) compared with women who did not (hazard ratio = 1.79, 95% confidence interval: 1.15, 2.78). Total cumulative years of menstrual cycling was inversely associated with GC risk (fifth vs. first quintile: hazard ratio = 0.55, 95% confidence interval: 0.31, 0.98; P-trend = 0.06). No other reproductive factors analyzed were associated with risk of GC. The results of this analysis provide some support for the hypothesis that endogenous ovarian sex hormones lower GC incidence in women.


  • Eric J. Duell
  • Noemie Travier
  • Leila Lujan-Barroso
  • M. C. Boutron-Ruault
  • F. Clavel-Chapelon
  • Domenico Palli
  • Vittorio Krogh
  • Amalia Mattiello
  • Rosario Tumino
  • Carlotta Sacerdote
  • Laudina Rodriguez
  • Emilio Sanchez-Cantalejo
  • Carmen Navarro
  • Aurelio Barricarte
  • Miren Dorronsoro
  • Kay-Tee Khaw
  • Nicholas Wareham
  • Naomi E. Allen
  • Konstantinos K. Tsilidis
  • H. Bas Bueno-de-Mesquita
  • Suzanne M. Jeurnink
  • M. E. Numans
  • Petra H. M. Peeters
  • Pagona Lagiou
  • Elisabeth Valanou
  • Antonia Trichopoulou
  • Rudolf Kaaks
  • Annekatrin Lukanova-McGregor
  • Manuela M. Bergman
  • Heiner Boeing
  • Bjorn Lindkvist
  • Roger Stenling
  • Goran Hallmans
  • Christina C. Dahm
  • Kim Overvad
  • Anja Olsen
  • Anne Tjonneland
  • Kjersti Bakken
  • Eiliv Lund
  • Mazda Jenab
  • Valerie McCormack
  • Sabina Rinaldi
  • Dominique Michaud
  • Traci Mouw
  • Gabriella Nesi
  • Fatima Carneiro
  • Elio Riboli
  • Carlos A. Gonzalez
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Public Health, Global Health, Social Medicine and Epidemiology


  • stomach neoplasms, reproduction, menstruation, estrogens, hormones, women
Original languageEnglish
Pages (from-to)1384-1393
JournalAmerican Journal of Epidemiology
Issue number12
Publication statusPublished - 2010
Publication categoryResearch