Abstract
BackgroundPublished findings suggest sex differences in lung cancer risk and a potential role for sex steroid hormones. Our aim was to perform a meta-analysis to investigate the effects of sex steroid hormone exposure specifically on the risk of lung cancer in women.MethodsThe PubMed, MEDLINE, Web of Science, and EMBASE databases were searched. The pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) for female lung cancer risk associated with sex steroid hormones were calculated overall and by study design, publication year, population, and smoking status. Sensitivity analysis, publication bias, and subgroup analysis were performed.ResultsForty-eight studies published between 1987 and 2019 were included in the study with a total of 31,592 female lung cancer cases and 1,416,320 subjects without lung cancer. Overall, higher levels of sex steroid hormones, both endogenous (OR: 0.92, 95% CI: 0.87–0.98) and exogenous (OR: 0.86, 95% CI: 0.80–0.93), significantly decreased the risk of female lung cancer by 10% (OR: 0.90, 95% CI: 0.86–0.95). The risk of lung cancer decreased more significantly with a higher level of sex steroid hormones in non-smoking women (OR: 0.88, 95% CI: 0.78–0.99) than in smoking women (OR: 0.98, 95% CI: 0.77–1.03), especially in Asia women (OR: 0.84, 95% CI: 0.74–0.96).ConclusionsOur meta-analysis reveals an association between higher levels of sex steroid hormone exposure and the decreased risk of female lung cancer. Surveillance of sex steroid hormones might be used for identifying populations at high risk for lung cancer, especially among non-smoking women.
Highlights
Published findings suggest sex differences in lung cancer risk and a potential role for sex steroid hormones
Our meta-analysis reveals an association between higher levels of sex steroid hormone exposure and the decreased risk of female lung cancer
Surveillance of sex steroid hormones might be used for identifying populations at high risk for lung cancer, especially among non-smoking women
Summary
Published findings suggest sex differences in lung cancer risk and a potential role for sex steroid hormones. Prevention of lung cancer based on tobacco control has been widely implemented worldwide; approximately 25% of lung cancer cases worldwide still occur in never-smokers, especially in women [3,4,5,6,7,8]. Due to the uncertain causes of lung cancer besides tobacco smoking, both the primary prevention of lung cancer and lung cancer screening strategy based on the identification of high-risk populations are difficult, especially among women and never-smokers. The different features existing between the genders are still unexplained, suggesting the existence of some factors associated with female lung cancer in addition to the common risk factors, such as tobacco smoking [15]
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