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Title: Menstrual factors, reproductive history, hormone use, and Urothelial carcinoma risk: A prospective study in the EPIC cohort
Author: Luján Barroso, Leila
Botteri, Edoardo
Caini, Saverio
Ljungberg, Börje
Roswall, Nina
Tjønneland, Anne
Bueno de Mesquita, H. Bas
Gram, Inger T.
Tumino, Rosario
Kiemeney, Lambertus A. L. M.
Liedberg, Fredrik
Stocks, Tanja
Gunter, Marc J.
Murphy, Neil
Cervenka, Iris
Fournier, Agnès
Kvaskoff, Marina
Häggström, Christel
Overvad, Kim
Lund, Eiliv
Waaseth, Marit
Fortner, Renée Turzanski
Kühn, Tilman
Menéndez, Virginia
Sánchez, María José
Santiuste, Carmen
Perez Cornago, Aurora
Zamora-Ros, Raul
Cross, Amanda J.
Trichopoulou, Antonia
Karakatsani, Anna
Peppa, Eleni
Palli, Domenico
Krogh, Vittorio
Sciannameo, Veronica
Mattiello, Amalia
Panico, Salvatore
van Gils, Carla H.
Onland-Moret, N. Charlotte
Barricarte, Aurelio
Amiano, Pilar
Khaw, Kay-Tee
Boeing, Heiner
Weiderpass, Elisabete
Duell, Eric J.
Keywords: Càncer de bufeta
Bladder cancer
Issue Date: 28-May-2020
Publisher: American Association for Cancer Research (AACR)
Abstract: Background: Urothelial carcinoma (UC) is the predominant (95%) bladder cancer subtype in industrialised nations. Animal and epidemiological human studies suggest that hormonal factors may influence UC risk. Methods: We used an analytic cohort of 333,919 women from the European Prospective Investigation into Cancer and Nutrition Cohort (EPIC). Associations between hormonal factors and incident UC (overall and by tumour grade, by tumour aggressiveness, and by non-muscle invasive UC) risk were evaluated using Cox proportional hazards models. All models were stratified by age at recruitment and study centre, and adjusted for smoking status and intensity, and fruit and vegetable intakes. Results: During a mean of 15 years of follow-up, 529 women developed UC. In a model including number of full-term pregnancies (FTP), menopausal status, and menopausal hormone therapy (MHT) showed an inverse association between, number of FTP was inversely associated with UC risk (HR≥5vs1=0.48, 0.25-0.90; P-trend in parous women=0.010) and MHT-use (compared to non-use) was positively associated with UC 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 analysis in never-smokers showed similar HR patterns for number of FTP and no association between MHT-use and UC risk. Association between MHT-use and UC risk only remained significant in current-smokers. No heterogeneity of the risk estimations in the final model was observed by tumour aggressiveness or by tumour grade. A positive association between the MTH-use and non-muscle invasive UC risk was observed. Conclusion: Increasing number of FTP may reduce UC risk. Our results provided limited evidence for a role of MHT-use in UC risk due to residual confounding by tobacco. Impact: More detailed studies on parity are needed to understand the possible effects of perinatal hormone changes in urothelial cells.
Note: Versió postprint del document publicat a:
It is part of: Cancer Epidemiology Biomarkers & Prevention, 2020, p. 1-30
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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