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Reproductive factors and risk of lung cancer in female textile workers in Shanghai, China

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Abstract

Purpose

Hormonal factors may play a role in the development of lung cancer in women. This study examined the relationship between lung cancer and reproductive factors in a large cohort of women, most of whom never smoked (97 %).

Methods

A cohort of 267,400 female textile workers in Shanghai, China, enrolled in a trial of breast self-examination provided information on reproductive history, demographical factors, and cigarette smoking at enrollment in 1989–91. The cohort was followed until July of 2000 for incidence of lung cancer; 824 cases were identified. Hazard ratios (HR) and 95 % confidence intervals (CI) associated with selected reproductive factors were calculated using Cox proportional hazards modeling, adjusting for smoking, age, and also parity when relevant.

Results

Nulliparous women were at increased risk compared to parous women (HR = 1.33, 95 % CI 1.00–1.77). Women who had gone through menopause at baseline were at increased risk compared to women of the same age who were still menstruating. Risk was higher in women with a surgical menopause (HR = 1.64, 95 % CI 0.96–2.79) than in those with a natural menopause (HR = 1.35, 95 % CI 0.84–2.18), and risk was highest in those postmenopausal women with a hysterectomy and bilateral oophorectomy at baseline (HR = 1.39, 95 % CI 0.96–2.00), although the risk estimates were not statistically significant.

Conclusions

These results support experimental data that demonstrate a biological role for hormones in lung carcinogenesis.

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Acknowledgments

The authors would like to acknowledge the Shanghai study manager (Wen Wan Wang), industrial hygienists and Shanghai field workers for their extensive efforts as well as George Astrakianakis, Noah Seixas, Janice Camp, Karen Wernli, and Dawn Fitzgibbons for their work on the endotoxin exposure assessment. Funding provided from the National Cancer Institute at the National Institutes of Health (R01CA80180). Dr. Applebaum was supported by K01OH009390.

Conflict of Interest

The authors declare that they have no conflict of interests.

Author information

Authors and Affiliations

  1. Department of Environmental and Occupational Health Sciences, University of Washington, Box 357234, Seattle, WA, 98195, USA

    Lisa G. Gallagher & Harvey Checkoway

  2. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA

    Karin A. Rosenblatt

  3. Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Roberta M. Ray, Wenjin Li & David B. Thomas

  4. Zhong Shan Hospital Cancer Center, Shanghai, China

    Dao L. Gao

  5. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    Katie M. Applebaum

  6. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Harvey Checkoway & David B. Thomas

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  1. Lisa G. Gallagher
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  2. Karin A. Rosenblatt
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  3. Roberta M. Ray
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  4. Wenjin Li
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Correspondence to Lisa G. Gallagher.

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Gallagher, L.G., Rosenblatt, K.A., Ray, R.M. et al. Reproductive factors and risk of lung cancer in female textile workers in Shanghai, China. Cancer Causes Control 24, 1305–1314 (2013). https://doi.org/10.1007/s10552-013-0208-y

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