Table 1.
Characteristics of observational studies addressing the association of gastric cancer with menstrual and reproductive factors, and with use of estrogen-related therapies.
| Authors, year (reference) |
Country where conducted |
Exposure(s) studied | Type of study |
Cases/controls (overall follow-up time) |
Comparison group |
Age range (menopausal status) |
Histologic type of cases | Anatomic site of cases | Confounders controlled |
|---|---|---|---|---|---|---|---|---|---|
| La Vecchia et al., 1994 (26) |
Italy | Age at menopause, age at menarche, years of fertility, parity, age at first birth, OC use, HRT use, history of spontaneous and induced abortions. |
Case- control |
229/614 | Hospital- based controls |
35–79 (all post menopausal) |
No data | No data | Age, education, area of residence, family history of gastric cancer, total calories, beta- carotene and vitamin C intake, and other hormone-related exposure variables |
| Palli et al., 1994 (27) |
Italy | Age at menopause a, age at menarche, years of fertility a, parity, age at first birth, number of spontaneous/induced abortions. |
Case- control |
339/515 | Population- based controls |
<75 (all post menopausal) |
No data | No data | Age, geographic area, place of residence, migration from the south, SES, family history of gastric cancer, BMI, total caloric intake and protein and ascorbic acid intake. |
| Heuch et al., 2000 (29) and Heuch et al., 2003 (33) |
Norway | Age at menopause, age at menarche, parity, age at first birth, number of abortions and duration of breastfeeding. |
Cohort | 572/~ 62,518 (1,442,514 p- yr) |
Participants in a screening program for breast cancer (1956– 1959) |
32–79 (pre and post- menopausal) |
No data | Cardia and fundus:58; corpus: 58; antrum and pylorus: 180; unspecified: 276 |
Age, birth cohort, area of residency and county. Parity and age at delivery were included in some models. |
| Inoue et al., 2002 (30) |
Japan | Age at menopause, age at menarche, menstrual irregularity, years of fertility, pregnancy, parity, age at first birth, number of children breastfed and duration of breastfeeding a. |
Case- control |
365/1,825 | Hospital- based controls |
39–82 (all post- menopausal) |
Differentiated: 133; undifferentiated: 232. |
Upper third: 72; middle third: 155; lower third: 127. |
Age, year and season of interview, family history of gastric cancer, smoking status and raw vegetable and cooked fish intake. |
| Kaneko et al., 2003 (31) |
Japan | Age at menopause, age at menarche, years of fertility, parity, age at first pregnancy, HRT use. |
Cohort | 156/~ 40,379 (330,786 p- yr) |
Participants in the JACC |
40–79 (all post- menopausal) |
No data | No data | Age. |
| Fernandez et al., 2003 (32) |
Italy | HRT use. | Case- control |
258/6,976 | Hospital- based controls |
45–79 | No data | No data | Age, study center, year of interview, education, smoking, drinking, type of menopause, age at menopause and BMI. |
| Frise et al., 2006 (35) |
Canada | Age at menopause, menopausal status, age at menarche a, years of fertility, parity, age at first pregnancy, OC use, use and duration of HRT, history of hysterectomy or oophorectomy. |
Case- control |
326/326 | Population- based controls |
20–74 (pre and post- menopausal) |
Intestinal: 55; diffuse: 106; mixed: 15; unknown: 150. |
Proximal: 49; distal: 176; overlapping: 13; unknown: 88. |
Age, education, meat consumption, and other hormone-related exposure variables. |
| Freedman et al., 2007 (36) |
China | Age at menopause a, menopausal status, age at menarche, years of fertility a, years since menopause, pregnancies, parity, age at first pregnancy, oral and injectable contraceptives use, IUD use a, HRT use, history of hysterectomy a or ovariectomy a, duration of breastfeeding. |
Cohort | 154/~73,288 (419,260 p- yr) |
Participants in the Shanghai Women’s Health Study |
40–70 (pre and post- menopausal) |
No data | No data | Age, BMI, education, income, cigarette smoking status, and smoking dose. |
| Sakauchi, 2007 (37) |
Japan | Age at menopause, age at menarche, type of menopause, years of fertility, pregnancies, parity, age at first delivery, use and duration of HRT. |
Cohort | 386/no data (~750,619 p- yr) |
Participants in the JACC |
all post- menopausal |
No data | No data | Age and area of study. |
| Persson et al., 2008 (38) |
Japan | Age at menopause, age at menarche, years of fertility, menstruation status menopause status, regularity of menstruation, age at first delivery, age at first pregnancy, pregnancies, number of deliveries, any hormone intake, breast-feeding, history of endometritis or vaginitis. |
Cohort | 368/~ 44,085 (541,862) |
Participants in the JPHC |
40–69 (pre and post- menopausal) |
Differentiated: 97; undifferentiated: 242, unclassified: 29. |
Proximal: 26, distal: 265, overlapping: 11, unspecified: 66. |
Age, family history of gastric cancer, and study area. |
| Bahmanyar et al., 2008 (39) |
Sweden | Age at first birth and parity. |
Nested case- control |
2,498/12,490 | Participants in a cohort of women born in 1925 or later |
≥30 (pre and post- menopausal) |
No data | Noncardia: 2498 | Year of birth, occupational class, education level, age at first birth and parity. |
| Dorjgochoo et al., 2009 (40) |
China | OC use, IDU use, tubal sterilization. |
Cohort | 168/~ 66,493 | Participants in the Shanghai Women’s Health Study |
40–70 (pre and post- menopausal) |
No data | No data | Age, education, age at menarche, number of live births, cumulative breast feeding months, BMI, exercised regularly in past 5 years, smoking, menopausal status, first- degree family history of cancer and other contraceptive methods |
| Freedman et al., 2010 (41) |
US | Age at menopause, age at menarche, parity, age at first birth, history of hysterectomy or oophorectomy, duration of OC use, use and duration of HRT. |
Cohort | 97/~ 201,409 | Participants in the NIH- AARP Diet and Health Study |
50–71 (pre and post- menopausal) |
No data | Noncardia: 97 | Age, BMI, fruit and vegetable consumption, smoking use, alcohol intake, physical activity, and total energy intake. |
| Duell et al., 2010 (11) |
European countries |
Age at menarche and menopause, duration of OC use, HRT use, parity, age at first full-term pregnancy, breastfeeding, miscarriage, induced abortion, ovariectomy, hysterectomy, and cumulative duration of menstrual cycling. |
Cohort | 181/~ 335,035 (2,927,994 p- yr) |
Participants in the EPIC |
35–70 (pre and post- menopausal) |
Intestinal: 48; diffuse: 82; mixed/unclassified/unknown: 53. |
Noncardia: 101; cardia: 31; overlapping/unknown: 49. |
Age, center, smoking status, education, BMI, and calorie- adjusted vegetable, fruit, red meat, and processed meat intakes. |
| Chung et al., 2011 (42) |
Korea | Age at menarche, age at first pregnancy, parity, history of lactation, and OC use. |
Case- control |
1,495/1,350 | Hospital- based controls |
18–45 (Pre and post- menopausal) |
No data | No data | Age. |
| Chang et al., 2011 (43) |
Taiwan | Parity | Cohort | 1,090/ ~1,291,372 (33,686,828 p-yr) |
Participants in a cohort of women with a record of a first and singleton childbirth in the Birth Registry between 1978 to 1987 |
(Pre and post- menopausal) |
No data | No data | Age, marital status, years of schooling and birthplace. |
| Green et al., 2011 (44) |
UK | HRT use. | Nested case- control |
750/3,722 | Participants in the GPRD |
50–84 (all post- menopausal) |
No data | No data | Age, calendar time and length of observation in GPRD, tobacco smoking, alcohol consumption, and BMI. |
Abbreviations: JAAC, Japan Collaborative Cohort Study; JPHC, Japan Public Health Center-based Prospective Study; EPIC, European Prospective Investigation into Cancer and Nutrition; BMI, body mass index; GPRD, UK General Research Database.
a
Statistically significant result.