Reproductive Cancer Risk Research Articles

Association of +331G/A PgR Polymorphism with Susceptibility to Female Reproductive Cancer: Evidence from a Meta-Analysis

The progesterone receptor (PgR), a sex steroid hormone receptor that binds progesterone is critical for normal breast development. The PgR (+331G/A, rs10895068) promoter polymorphism is associated with cancer risk possibly by altering the expression of progesterone receptor B isoform. Previous studies have provided inconsistent results. To validate the association between the PgR +331G/A polymorphism and female reproductive cancer risk (breast, endometrial and ovarian cancer), we performed a meta-analysis of 19 studies (19,978 cases and 24,525 controls) by using the CMA Version 2 software. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the strength of the associations. The overall results indicated that the variant allele and genotypes were associated with a mild increase in overall female reproductive cancer risk (A vs. G: OR = 1.063, 95% CI = 1.001–1.129; AA+AG vs. GG: OR = 1.067, 95% CI = 1.002–1.136). The results suggest that the PgR +331G/A polymorphism might be associated with an increased female reproductive cancer risk.

Reproductive Cancer Risk Factors among Alaska Native Women: The Alaska Education and Research Towards Health (EARTH) Study

BackgroundThe purpose of this study was to provide estimates for the prevalence of reproductive cancer risk factors among Alaska Native (AN) women who enrolled in the Alaska Education and Research Towards Health (EARTH) Study from 2004 to 2006. MethodsA total of 2,315 AN women 18 years or older completed reproductive health questions as part of a comprehensive health history questionnaire. The reproductive health section included menstrual status (age at menarche and menopause), pregnancy and live birth history, use of hormonal contraception, hormone replacement therapy, and history of hysterectomy and/or oophorectomy. ResultsA total of 463 (20%) of women experienced menarche before age 12 with a decline in mean age at menarche by age cohort. More than 86% had been pregnant (mean number of pregnancies, 3.8; mean number of live births, 2.9). More than one half of women (58%) had their first live birth between the ages of 18 and 24. Almost 28% of participants had completed menopause, of whom 24% completed menopause after age 52. Fewer than half (43%) reported ever using hormone replacement therapy. Almost two thirds (62%) reported ever using oral contraceptives, and fewer reported ever using birth control shots (30%) or implants (10%). ConclusionsThis study is unique in reporting reproductive health factors among a large group of AN women. These data show that AN women have selective protective factors for reproductive cancers, including low nulliparity rates, low use of menopausal estrogens, and common use of contraceptive hormones. However, analysis by age cohorts indicates decreasing age at menarche that might increase the risk for reproductive cancers among AN women in the future.

Variability of reproductive history across the Swiss SAPALDIA cohort – Patterns and main determinants

Background: Reproductive characteristics play an aetiological role for many diseases, including reproductive cancers. They have been shown to vary internationally and nationally, but have not yet been described for the whole Swiss population.Aim: The study investigated the variability of reproductive characteristics, their patterns, and main determinants across a population-based female study population in Switzerland.Methods: Reproductive characteristics obtained from 3119 women (28–72 years) participating in the SAPALDIA cohort survey in 2001–2003 are described across birth cohorts, study areas, language regions, and levels of urbanization. Determinants of age at menopause were analysed by Cox regression.Results: Reported median age at menarche was 13 years and median age at natural menopause was 52 years. The prevalence of nulliparity was 27%, and the fertility rate 1.6. Across birth cohorts there was a decline of menarcheal age and fertility rates, and an increase of nulliparity and age at last pregnancy. All characteristics varied across study areas, language regions, and levels of urbanization. Smoking, parity, and physical exercise were stronger predictors of earlier (<52 years) than older (>52 years) menopausal age.Conclusion: Reproductive events show secular and geographic variation within Switzerland. Smoking, parity and physical activity significantly predict age at natural menopause, particularly before age 52. The secular trend of earlier menarche and increased nulliparity may result in a higher risk of reproductive cancers in younger generations.

Reproductive health history of lesbians: implications for care*1

<h2>Abstract</h2><h3>Objective</h3> Parity and hormonal contraceptives modify the risk of reproductive cancers and cardiovascular disease. However, clinicians may not obtain reproductive histories from patients who self-identify as lesbian. We report lifetime pregnancy-related outcomes and hormonal contraception for 392 women who reported sexual activity with another woman in the preceding year. <h3>Study design</h3> Among self-referred volunteers, previous pregnancy, pregnancy outcome, contraceptive use, and sexual identity were assessed with self-administered questionnaire. <h3>Results</h3> One in 4 subjects had been pregnant, and more than 50% of the women had used oral contraceptives (mean duration, 40 months). Sixteen percent of all subjects and 63% of those who had been pregnant previously reported having 1 or more induced abortions. The most common pregnancy outcome for women younger than 25 years was induced abortion (59% of pregnancies). Identifying as "lesbian" or "bisexual" predicted neither the duration of oral contraceptive use nor a report of induced abortion. <h3>Conclusion</h3> Previous pregnancy, induced abortion, and hormonal contraceptive use are common among women who report sex with women, regardless of self-identification as lesbian.

Reproductive health history of lesbians: implications for care

Objective Parity and hormonal contraceptives modify the risk of reproductive cancers and cardiovascular disease. However, clinicians may not obtain reproductive histories from patients who self-identify as lesbian. We report lifetime pregnancy-related outcomes and hormonal contraception for 392 women who reported sexual activity with another woman in the preceding year. Study design Among self-referred volunteers, previous pregnancy, pregnancy outcome, contraceptive use, and sexual identity were assessed with self-administered questionnaire. Results One in 4 subjects had been pregnant, and more than 50% of the women had used oral contraceptives (mean duration, 40 months). Sixteen percent of all subjects and 63% of those who had been pregnant previously reported having 1 or more induced abortions. The most common pregnancy outcome for women younger than 25 years was induced abortion (59% of pregnancies). Identifying as “lesbian” or “bisexual” predicted neither the duration of oral contraceptive use nor a report of induced abortion. Conclusion Previous pregnancy, induced abortion, and hormonal contraceptive use are common among women who report sex with women, regardless of self-identification as lesbian.

Hormone Replacement Therapy and the Risk of Reproductive Cancers

The current literature evaluating the associations between hormone replacement therapy (HRT) and breast, endometrial and ovarian cancers is reviewed. These associations are examined in the context of risks conveyed by exposure to endogenous hormones, as well as other exogenous exposures, particularly oral contraceptive use. The extensive and controversial literature on HRT and breast cancer risk is reviewed in detail. On balance, these data suggest a small increased risk (RR = 1.2–1.3) for long-term, current users of HRT. The most recent and largest cohort study found a greater risk, even for lower estrogen formulations (≤ 0.625 mg/day), particularly among older women who have used HRT for at least 5 years (RR = 1.7). There is little evidence that the addition of progestin protects against this risk. The extent to which associations vary by: subject characteristics (such as type of menopause, or family history), exposure characteristics (dose, duration and type of hormone) and study design issues (study quality, case-control vs. cohort) is discussed. The well-documented duration-dependent increase in endometrial cancer with unopposed estrogen (RR = 9.5 for 10+ years) is reviewed briefly, as well as the somewhat weaker data suggesting little or no increased risk with the addition of progestin for at least 10 days per cycle. The limited data available on HRT and ovarian cancer risk, suggesting little or no association, are also presented.

Hormone replacement and cancer.

The increasing extended use of noncontraceptive oestrogen by postmenopausal women, intended to prevent other conditions, may at the same time increase their risk of reproductive cancer. The risk of endometrial cancer triples after only a few years of unopposed oestrogen, persists for many years after oestrogen has been discontinued, and appears to be preventable by the addition of a progestin. The effect of replacement hormones on the risk of breast or ovarian cancer is unknown. Most studies suggest a small but significant increased risk of breast cancer after long-term use. Awareness of the known and uncertain cancer risks should be included in decisions to use replacement hormones.