Table 3.
Associations Between Menopausal Factors and Lung Cancer Among 185,017 Women, NIH-AARP Diet and Health Study, 1995–2006
| Characteristic | N=185,017 | Person-years | # Lung Cancers n=3,512 | Age-adjusted RR* | 95% CI | Multivariate RR† | 95% CI |
|---|---|---|---|---|---|---|---|
| Natural menopause | |||||||
| <45 years | 12,892 | 124,289 | 372 | 1.80 | 1.59 2.04 | 1.29 | 1.14 1.46 |
| 45–49 years | 29,948 | 292,997 | 641 | 1.38 | 1.24 1.53 | 1.12 | 1.01 1.24 |
| 50–54 years | 51,647 | 510,483 | 817 | 1.00 | (referent) | 1.00 | (referent) |
| 55+ years | 11,543 | 114,063 | 162 | 0.82 | 0.69 0.97 | 0.98 | 0.82 1.16 |
| p-value for trend‡ | <0.0001 | <0.0001 | |||||
| Surgical menopause, bilateral oophorectomy | |||||||
| <40 years | 12,344 | 119,546 | 317 | 1.74 | 1.53 1.98 | 1.31 | 1.15 1.50 |
| 40–44 years | 9,409 | 92,357 | 198 | 1.33 | 1.14 1.55 | 1.18 | 1.01 1.38 |
| 45–49 years | 9,718 | 96,049 | 160 | 1.05 | 0.89 1.25 | 1.07 | 0.90 1.26 |
| 50+ years | 5,981 | 59,403 | 85 | 0.88 | 0.70 1.10 | 1.05 | 0.84 1.31 |
| p-value for trend‡ | <0.0001 | 0.01 | |||||
| Surgical menopause, both ovaries intact | |||||||
| <40 years | 14,111 | 137,963 | 254 | 1.25 | 1.09 1.44 | 1.12 | 0.97 1.29 |
| 40–44 years | 7,686 | 75,400 | 154 | 1.26 | 1.06 1.49 | 1.20 | 1.01 1.43 |
| 45+ years | 6,639 | 65,248 | 105 | 0.97 | 0.79 1.18 | 1.04 | 0.85 1.28 |
| p-value for trend‡ | 0.04 | 0.71 | |||||
| Unknown type of menopause | 7,693 | 75,240 | 167 | 1.40 | 1.19 1.65 | 1.24 | 1.05 1.46 |
| Unknown age at menopause | 5,406 | 53,310 | 80 | 0.97 | 0.77 1.22 | 0.97 | 0.76 1.23 |
| Menopausal hormone use | |||||||
| Never used | 84,862 | 827,111 | 1,808 | 1.00 | (referent) | 1.00 | (referent) |
| Current user | 82,562 | 817,358 | 1,362 | 0.84 | 0.78 0.90 | 0.94 | 0.87 1.02 |
| Former user | 17,150 | 167,481 | 336 | 0.93 | 0.83 1.04 | 0.92 | 0.82 1.04 |
| Missing | 443 | 4,398 | 6 | 0.64 | 0.29 1.43 | 0.64 | 0.29 1.44 |
| Years of use of menopausal hormones | |||||||
| Never used | 81,347 | 793,009 | 1,715 | 1.00 | (referent) | 1.00 | (referent) |
| <5 years | 35,310 | 349,033 | 561 | 0.86 | 0.78 0.95 | 0.96 | 0.87 1.06 |
| 5–9 years | 25,088 | 249,257 | 364 | 0.77 | 0.69 0.86 | 0.92 | 0.82 1.04 |
| 10+ years | 39,499 | 388,348 | 776 | 0.92 | 0.84 1.00 | 0.95 | 0.87 1.05 |
| Missing | 3,773 | 36,702 | 96 | 1.20 | 0.98 1.48 | 1.27 | 1.03 1.57 |
| p-value for trend | <0.01 | 0.21 | |||||
*
Relative risks (RR) and 95% confidence intervals (CI) from Cox models adjusted for age at entry into cohort.
†
Relative risks (RR) and 95% confidence intervals (CI) from Cox models adjusted for age at entry into cohort, race/ethnicity, education, body mass index, emphysema, age at menarche, and smoking status and dose.
‡
Trends were calculated within menopause subgroups, using the youngest age as the referent, despite the use of a different referent group for the calculation of RRs.