Cancer Causes & Control

, Volume 23, Issue 12, pp 2041–2046 | Cite as

Reproductive history and risk of small bowel cancer by histologic type: a population-based study

  • Yunxia Lu
  • Mats Lambe
  • Anna Martling
  • Jesper Lagergren
Brief report



The male predominance of the two main histologic malignancies of the small bowel cancer may reflect a role of sex hormones which will be examined in this study.


This was a nationwide population-based nested case–control study, based on a cohort of subjects born between 1932 and 2008, as identified in the Swedish Multi-Generation Register. For each case of small bowel cancer, 10 age- and sex-matched controls were randomly selected. Number of children and age at having the first child were analyzed in relation to the risk of small bowel cancer using conditional logistic regression, providing odds ratios (ORs) and 95 % confidence intervals (CIs).


A total of 632 female cases and 894 male cases of small bowel cancer were included. No overall increased risk of small bowel cancer was found in parous compared to non-parous women (OR = 1.02, 95 % CI 0.67–1.54). There was no association between age at first birth and small bowel cancer (>30 years of age vs <20 years; OR = 1.04, 95 % CI 0.72–1.50). No associations were detected in separate analyses of adenocarcinoma or carcinoid of the small bowel. No distinct risk patterns were discerned in men compared to women.


Reproductive history does not seem to be associated with the risk of small bowel cancer, independent of histologic type.


Small bowel cancer Parity Age at first birth Adenocarcinoma Carcinoid 



The Swedish Research Council (SIMSAM) funded the study. We are also grateful for Sandra Eloranta’s comments for statistical analysis.

Conflict of interest

No potential competing interests to disclose.


  1. 1.
    Bilimoria KY, Bentrem DJ, Wayne JD et al (2009) Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg 249:63–71PubMedCrossRefGoogle Scholar
  2. 2.
    Haselkorn T, Whittemore AS, Lilienfeld DE (2005) Incidence of small bowel cancer in the United States and worldwide: geographic, temporal, and racial differences. Cancer Causes Control 16:781–787PubMedCrossRefGoogle Scholar
  3. 3.
    Gustafsson BI, Siddique L, Chan A et al (2008) Uncommon cancers of the small intestine, appendix and colon: an analysis of SEER 1973–2004, and current diagnosis and therapy. Int J Oncol 33:1121–1131PubMedGoogle Scholar
  4. 4.
    Qubaiah O, Devesa SS, Platz CE et al (2010) Small intestinal cancer: a population-based study of incidence and survival patterns in the United States, 1992 to 2006. Cancer Epidemiol Biomarkers Prevent 19:1908–1918CrossRefGoogle Scholar
  5. 5.
    Lu Y, Frobom R, Lagergren J (2012) Incidence patterns of small bowel cancer in a population-based study in Sweden: increase in duodenal adenocarcinoma. Cancer Epidemiol 36:e158–e163PubMedCrossRefGoogle Scholar
  6. 6.
    Hemminki K, Li X (2001) Incidence trends and risk factors of carcinoid tumors: a nationwide epidemiologic study from Sweden. Cancer 92:2204–2210PubMedCrossRefGoogle Scholar
  7. 7.
    Freedman ND, Chow WH, Gao YT et al (2007) Menstrual and reproductive factors and gastric cancer risk in a large prospective study of women. Gut 56:1671–1677PubMedCrossRefGoogle Scholar
  8. 8.
    Kaneko S, Tamakoshi A, Ohno Y et al (2003) Menstrual and reproductive factors and the mortality risk of gastric cancer in Japanese menopausal females. Cancer Causes Control 14:53–59PubMedCrossRefGoogle Scholar
  9. 9.
    Wernli KJ, Wang Y, Zheng Y et al (2009). The Relationship between Gravidity and Parity and Colorectal Cancer Risk. J Womens Health (Larchmt) 18(7):995–1001Google Scholar
  10. 10.
    Lu Y, Lagergren J. (2012) Reproductive factors and risk of oesophageal cancer, a population-based nested case-control study in Sweden. Br J Cancer 107:564–569Google Scholar
  11. 11.
    Barlow L, Westergren K, Holmberg L et al (1998) The completeness of the Swedish Cancer Register—a sample survey for year. Acta Oncol 2008:1–7Google Scholar
  12. 12.
    Ludvigsson JF, Andersson E, Ekbom A et al (2011) External review and validation of the Swedish national inpatient register. BMC public health 11:450PubMedCrossRefGoogle Scholar
  13. 13.
    McKnight B, Cook LS, Weiss NS (1999) Logistic regression analysis for more than one characteristic of exposure. Am J Epidemiol 149:984–992PubMedCrossRefGoogle Scholar
  14. 14.
    (2000) Yearbook of health and medical care. National Board of Health and Welfare, StockholmGoogle Scholar
  15. 15.
    Rutegard M, Shore R, Lu Y et al (2010) Sex differences in the incidence of gastrointestinal adenocarcinoma in Sweden 1970–2006. Eur J Cancer 46:1093–1100PubMedCrossRefGoogle Scholar
  16. 16.
    Lindblad M, Ye W, Rubio C et al (2004) Estrogen and risk of gastric cancer: a protective effect in a nationwide cohort study of patients with prostate cancer in Sweden. Cancer Epidemiol, Biomarkers Prevent 13:2203–2207Google Scholar
  17. 17.
    Newton JN, Swerdlow AJ, dos Santos Silva IM et al (1994) The epidemiology of carcinoid tumours in England and Scotland. Br J Cancer 70:939–942PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Yunxia Lu
    • 1
  • Mats Lambe
    • 2
    • 3
  • Anna Martling
    • 4
  • Jesper Lagergren
    • 1
    • 5
  1. 1.Upper Gastrointestinal Research, Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
  2. 2.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
  3. 3.Regional Cancer CenterUniversity HospitalUppsalaSweden
  4. 4.Lower Gastrointestinal Research Group, Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
  5. 5.Division of Cancer StudiesKing’s College LondonLondonUK

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