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Relationship between female hormonal and menstrual factors and pancreatic cancer: a meta-analysis of observational studies.

Tang B, Lv J, Li Y, Yuan S, Wang Z, He S - Medicine (Baltimore) (2015)

Bottom Line: Combined relative risks (RRs) were estimated by random-effects models.Sensitivity analyses and publication bias were utilized to evaluate the robustness of our results.No significant associations were observed between the risk of PC and age at menarche (RR = 0.94, 95% confidence interval [CI] 0.83-1.07), age at menopause (RR = 0.98, 95% CI 0.85-1.13), hysterectomy (RR = 0.97, 95% CI 0.84-1.11), oophorectomy (RR = 1.02, 95% CI 0.82-1.26), hormone replacement therapy (RR = 0.97, 95% CI 0.87-1.08), and oral contraceptives (RR = 1.09, 95% CI 0.96-1.23).

View Article: PubMed Central - PubMed

Affiliation: From the Department of Hepatobiliary Surgery (BT, SY, ZW, SH), Affiliated Hospital of Guilin Medical University; Laboratory of Liver Injury and Repair Molecular Medicine (BT, SH), Guilin Medical University, Guilin; Department of Infectious Diseases (JL), People's Hospital of Beihai, Beihai; and Department of Medical Oncology (YL), Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People's Republic of China.

ABSTRACT
The objective of this study was to assess the relationship between female hormone and menstrual factors and pancreatic cancer (PC) through a meta-analysis of observational studies. We undertook a systematic literature search up to July 10, 2014 in PubMed and EMBASE databases. Combined relative risks (RRs) were estimated by random-effects models. Subgroup analysis was performed by study design, source of control, and geographic regions. Sensitivity analyses and publication bias were utilized to evaluate the robustness of our results. A total of 27 case-control and cohort studies were retrieved for this meta-analysis. No significant associations were observed between the risk of PC and age at menarche (RR = 0.94, 95% confidence interval [CI] 0.83-1.07), age at menopause (RR = 0.98, 95% CI 0.85-1.13), hysterectomy (RR = 0.97, 95% CI 0.84-1.11), oophorectomy (RR = 1.02, 95% CI 0.82-1.26), hormone replacement therapy (RR = 0.97, 95% CI 0.87-1.08), and oral contraceptives (RR = 1.09, 95% CI 0.96-1.23). This meta-analysis of observational studies does not support the hypothesis that exogenous hormone use and menstrual factors are associated with PC.

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Sensitivity analyses for OC. CI = confidence interval, OC = oral contraceptive.
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Figure 8: Sensitivity analyses for OC. CI = confidence interval, OC = oral contraceptive.

Mentions: In the sensitivity analysis, one single study was excluded at a time to investigate the influence of individual study on the overall results. Sensitivity analysis demonstrated that the results of OC were not robust (Figure 8). When excluding the study conducted by Kreiger et al,23 an increased risk of borderline significance was found (RR = 1.12, 95% CI 1.00–1.24). For other exposures, the results were not meaningfully changed (data not shown). In addition, we performed an alternative sensitivity analysis to investigate whether the overall results were influenced by potential confounders or not. The results were shown in Table 2. All results were not significantly modified by smoking, body mass index (BMI), or diabetes except for OC. When we performed an analysis limited to those studies that provided risk estimates adjusted for smoking, BMI, and diabetes, a meaningful association between OC and PC risk was detected (RR = 1.19, 95% CI 1.02–1.40).


Relationship between female hormonal and menstrual factors and pancreatic cancer: a meta-analysis of observational studies.

Tang B, Lv J, Li Y, Yuan S, Wang Z, He S - Medicine (Baltimore) (2015)

Sensitivity analyses for OC. CI = confidence interval, OC = oral contraceptive.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554173&req=5

Figure 8: Sensitivity analyses for OC. CI = confidence interval, OC = oral contraceptive.
Mentions: In the sensitivity analysis, one single study was excluded at a time to investigate the influence of individual study on the overall results. Sensitivity analysis demonstrated that the results of OC were not robust (Figure 8). When excluding the study conducted by Kreiger et al,23 an increased risk of borderline significance was found (RR = 1.12, 95% CI 1.00–1.24). For other exposures, the results were not meaningfully changed (data not shown). In addition, we performed an alternative sensitivity analysis to investigate whether the overall results were influenced by potential confounders or not. The results were shown in Table 2. All results were not significantly modified by smoking, body mass index (BMI), or diabetes except for OC. When we performed an analysis limited to those studies that provided risk estimates adjusted for smoking, BMI, and diabetes, a meaningful association between OC and PC risk was detected (RR = 1.19, 95% CI 1.02–1.40).

Bottom Line: Combined relative risks (RRs) were estimated by random-effects models.Sensitivity analyses and publication bias were utilized to evaluate the robustness of our results.No significant associations were observed between the risk of PC and age at menarche (RR = 0.94, 95% confidence interval [CI] 0.83-1.07), age at menopause (RR = 0.98, 95% CI 0.85-1.13), hysterectomy (RR = 0.97, 95% CI 0.84-1.11), oophorectomy (RR = 1.02, 95% CI 0.82-1.26), hormone replacement therapy (RR = 0.97, 95% CI 0.87-1.08), and oral contraceptives (RR = 1.09, 95% CI 0.96-1.23).

View Article: PubMed Central - PubMed

Affiliation: From the Department of Hepatobiliary Surgery (BT, SY, ZW, SH), Affiliated Hospital of Guilin Medical University; Laboratory of Liver Injury and Repair Molecular Medicine (BT, SH), Guilin Medical University, Guilin; Department of Infectious Diseases (JL), People's Hospital of Beihai, Beihai; and Department of Medical Oncology (YL), Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People's Republic of China.

ABSTRACT
The objective of this study was to assess the relationship between female hormone and menstrual factors and pancreatic cancer (PC) through a meta-analysis of observational studies. We undertook a systematic literature search up to July 10, 2014 in PubMed and EMBASE databases. Combined relative risks (RRs) were estimated by random-effects models. Subgroup analysis was performed by study design, source of control, and geographic regions. Sensitivity analyses and publication bias were utilized to evaluate the robustness of our results. A total of 27 case-control and cohort studies were retrieved for this meta-analysis. No significant associations were observed between the risk of PC and age at menarche (RR = 0.94, 95% confidence interval [CI] 0.83-1.07), age at menopause (RR = 0.98, 95% CI 0.85-1.13), hysterectomy (RR = 0.97, 95% CI 0.84-1.11), oophorectomy (RR = 1.02, 95% CI 0.82-1.26), hormone replacement therapy (RR = 0.97, 95% CI 0.87-1.08), and oral contraceptives (RR = 1.09, 95% CI 0.96-1.23). This meta-analysis of observational studies does not support the hypothesis that exogenous hormone use and menstrual factors are associated with PC.

Show MeSH
Related in: MedlinePlus