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Jackson SS, Adami HO, Andreotti G, Beane-Freeman LE, de González AB, Buring JE, Fraser GE, Freedman ND, Gapstur SM, Gierach G, Giles GG, Grodstein F, Hartge P, Jenab M, Kirsh V, Knutsen SF, Lan Q, Larsson SC, Lee IM, Lee MH, Liao LM, Milne RL, Monroe KR, Neuhouser ML, O'Brien KM, Petrick JL, Purdue MP, Rohan TE, Sandin S, Sandler DP, Sawada N, Shadyab AH, Simon TG, Sinha R, Stolzenberg-Solomon R, Tsugane S, Weiderpass E, Wolk A, Yang HI, Zheng W, McGlynn KA, Campbell PT, Koshiol J. Associations between reproductive factors and biliary tract cancers in women from the Biliary Tract Cancers Pooling Project. J Hepatol 2020; 73:863-872. [PMID: 32437829 PMCID: PMC7901003 DOI: 10.1016/j.jhep.2020.04.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND & AIMS Gallbladder cancer (GBC) is known to have a female predominance while other biliary tract cancers (BTCs) have a male predominance. However, the role of female reproductive factors in BTC etiology remains unclear. METHODS We pooled data from 19 studies of >1.5 million women participating in the Biliary Tract Cancers Pooling Project to examine the associations of parity, age at menarche, reproductive years, and age at menopause with BTC. Associations for age at menarche and reproductive years with BTC were analyzed separately for Asian and non-Asian women. Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models, stratified by study. RESULTS During 21,681,798 person-years of follow-up, 875 cases of GBC, 379 of intrahepatic bile duct cancer (IHBDC), 450 of extrahepatic bile duct cancer (EHBDC), and 261 of ampulla of Vater cancer (AVC) occurred. High parity was associated with risk of GBC (HR ≥5 vs. 0 births 1.72; 95% CI 1.25-2.38). Age at menarche (HR per year increase 1.15; 95% CI 1.06-1.24) was associated with GBC risk in Asian women while reproductive years were associated with GBC risk (HR per 5 years 1.13; 95% CI 1.04-1.22) in non-Asian women. Later age at menarche was associated with IHBDC (HR 1.19; 95% CI 1.09-1.31) and EHBDC (HR 1.11; 95% CI 1.01-1.22) in Asian women only. CONCLUSION We observed an increased risk of GBC with increasing parity. Among Asian women, older age at menarche was associated with increased risk for GBC, IHBDC, and EHBDC, while increasing reproductive years was associated with GBC in non-Asian women. These results suggest that sex hormones have distinct effects on cancers across the biliary tract that vary by geography. LAY SUMMARY Our findings show that the risk of gallbladder cancer is increased among women who have given birth (especially women with 5 or more children). In women from Asian countries, later age at menarche increases the risk of gallbladder cancer, intrahepatic bile duct cancer and extrahepatic bile duct cancer. We did not see this same association in women from Western countries. Age at menopause was not associated with the risk of any biliary tract cancers.
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Affiliation(s)
- Sarah S Jackson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gabriella Andreotti
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Laura E Beane-Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Julie E Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Gary E Fraser
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Susan M Gapstur
- Behavioral and Epidemiology Research Group, American Cancer Society, Inc., Atlanta, GA, USA
| | - Gretchen Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Francine Grodstein
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Mazda Jenab
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Victoria Kirsh
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Mei-Hsuan Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Kristine R Monroe
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Marian L Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Tracey G Simon
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical, Boston, MA, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Alicja Wolk
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Hwai-I Yang
- Genomics Research Center, Academia Sinica, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Peter T Campbell
- Behavioral and Epidemiology Research Group, American Cancer Society, Inc., Atlanta, GA, USA
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Sun X, Zhang R, Wang L, Shen X, Lu Y, An J, Wang L, Wang Y, Luo X, Zhu H, Zhang X. Association Between Parity and the Age at Menopause and Menopausal Syndrome in Northwest China. Asia Pac J Public Health 2020; 33:60-66. [PMID: 32975428 DOI: 10.1177/1010539520960987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study evaluated the relationships between parity and the age at menopause and menopausal syndrome among Chinese women in Gansu. A total of 7236 women aged 40 to 55 years met study eligibility criteria. The modified Kupperman Menopausal Index scale was used to assess the severity of menopausal syndrome. Cox regression was applied to estimate hazard ratio and 95% confidence interval, and logistic regression was performed to calculate odds ratio and confidence interval. The mean age at menopause was 47.91 ± 3.31 years. There is no relationship between parity and age at menopause. Women with nulliparity or multiparity seemed to have higher risks of moderate and severe menopausal syndrome. The potential beneficial effects of one or two births on menopausal syndrome were also observed by applying the multivariable logistic regression analysis, particularly in urogenital symptoms. Women with nulliparity and multiparity appeared to be at the higher risks of menopause syndrome.
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Affiliation(s)
- Xiaoyan Sun
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - Rui Zhang
- The Reproductive Medicine Special Hospital, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Lirong Wang
- The Reproductive Medicine Special Hospital, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | | | - Yongbin Lu
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - Junxia An
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - Liyan Wang
- The Reproductive Medicine Special Hospital, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.,Key Laboratory for Reproductive Medicine and Embryo of Gansu Province, Lanzhou, Gansu, China
| | - Yiqing Wang
- The Reproductive Medicine Special Hospital, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.,Key Laboratory for Reproductive Medicine and Embryo of Gansu Province, Lanzhou, Gansu, China
| | - Xiaorong Luo
- The Reproductive Medicine Special Hospital, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Haiying Zhu
- The Reproductive Medicine Special Hospital, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Xuehong Zhang
- The Reproductive Medicine Special Hospital, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.,Key Laboratory for Reproductive Medicine and Embryo of Gansu Province, Lanzhou, Gansu, China
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Kojima G, Ogawa K, Iliffe S, Taniguchi Y, Walters K. Number of Pregnancies and Trajectory of Frailty Index: English Longitudinal Study of Ageing. J Am Med Dir Assoc 2020; 21:1249-1253.e1. [PMID: 32522494 DOI: 10.1016/j.jamda.2020.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/10/2020] [Accepted: 04/11/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Women are frailer than men across different populations and age groups. However, the mechanisms are still not fully understood. One possible cause is pregnancy and motherhood. The objective of this study was to examine trajectories of Frailty Index over time according to the number of pregnancies. DESIGN A prospective study with repeated measures over 14 years. SETTING AND PARTICIPANTS A total of 2060 community-dwelling older women aged ≥60 years in England. METHODS The number of pregnancies was calculated as a sum of the number of live births and the number of miscarriages, still-births, or abortions. The Frailty Index (FI) was constructed using 60 deficits and repeatedly calculated every 2 years over 14 years. Trajectories of FI according to the number of pregnancies were estimated by a mixed effects model. RESULTS Mean FI was 0.15 at baseline. A mixed effects model adjusted for age, smoking, alcohol use, education, and wealth showed that FI increased over time. A higher number of pregnancies were significantly associated with a higher FI (estimate = 0.0047, 95% confidence interval = 0.0020, 0.0074). CONCLUSIONS AND IMPLICATIONS The current study showed that a higher number of pregnancies were significantly associated with a higher degree of frailty at baseline and over time. Pregnancy and child rearing may explain some of the observed excess risk of frailty in women. Pregnancy-related factors, such as pregnancy loss, types of delivery, length of pregnancy, childbearing, and child rearing, should be examined in relation to frailty in future studies.
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Affiliation(s)
- Gotaro Kojima
- Videbimus Clinic Research Center, Tokyo, Japan; Department of Primary Care and Population Health, University College London, London, United Kingdom.
| | - Kohei Ogawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Steve Iliffe
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London, United Kingdom
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Lugo A, Peveri G, Gallus S. Should we consider gallbladder cancer a new smoking‐related cancer? A comprehensive meta‐analysis focused on dose–response relationships. Int J Cancer 2019; 146:3304-3311. [DOI: 10.1002/ijc.32681] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/29/2019] [Accepted: 09/06/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Alessandra Lugo
- Department of Environmental Health Sciences Istituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
| | - Giulia Peveri
- Department of Molecular and Translational Medicine Università degli Studi di Brescia Brescia Italy
| | - Silvano Gallus
- Department of Environmental Health Sciences Istituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
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Xu C, Thabane L, Liu T, Borhan A, Sun X. Flexible piecewise linear model for investigating dose-response relationship in meta-analysis: Methodology, examples, and comparison. J Evid Based Med 2019; 12:63-68. [PMID: 30724020 DOI: 10.1111/jebm.12339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/31/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Dose-response meta-analysis (DRMA) is widely employed in establishing the potential dose-response relationship between continuous exposures and disease outcomes. However, there is no valid DRMA method readily for discrete exposures, especially when the possible dose-response trend not likely to be linear. We proposed a piecewise linear DRMA model as a solution to this issue. METHODS We illustrated the methodology of piecewise linear model in both one-stage DRMA approach and two-stage DRMA approach. The method by testing the equality of slopes of each piecewise was employed to judge if there is "piecewise effect" against a simple linear trend. We then used sleep (continuous exposure) and parity (discrete exposure) data as examples to illustrate how to apply the model in DRMA using the Stata code attached. We also empirically compared the slopes of piecewise linear model with simple linear as well as restricted cubic spline model. RESULTS Both one-stage and two-stage piecewise linear DRMA model fitted well in our examples, and the results were similar. Obvious "piecewise effects" were detected in both the two samples by the method we used. In our example, the new model showed a better fitting effect and practical, reliable results compared to the simple linear model, while similar results for to restricted cubic spline model. CONCLUSION Piecewise linear function is a valid and straightforward method for DRMA and can be used for discrete exposures, especially when the simple linear function is under fitted. It represents a superior model to linear model in DRMA and may be an alternative model to the nonlinear model.
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Affiliation(s)
- Chang Xu
- Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu, PR China
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada
| | - Tongzu Liu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, PR China
| | - Asm Borhan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada
| | - Xin Sun
- Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu, PR China
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Alvergne A, Högqvist Tabor V. Is Female Health Cyclical? Evolutionary Perspectives on Menstruation. Trends Ecol Evol 2018; 33:399-414. [DOI: 10.1016/j.tree.2018.03.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/23/2018] [Accepted: 03/26/2018] [Indexed: 12/19/2022]
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Wang Y, Xiong J, Niu M, Chen X, Gao L, Wu Q, Zheng K, Xu K. Statins and the risk of cirrhosis in hepatitis B or C patients: a systematic review and dose-response meta-analysis of observational studies. Oncotarget 2017; 8:59666-59676. [PMID: 28938670 PMCID: PMC5601766 DOI: 10.18632/oncotarget.19611] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/18/2017] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B and hepatitis C are leading causes of chronic liver disease, particularly cirrhosis. Recently, several studies have observed that statins have an inverse relationship with cirrhosis in hepatitis B or C patients. However, no published meta-analysis studied the protective effect of statins on cirrhosis. Thus, we conducted a systematic review and meta-analysis of published observational studies to better understand the relationship between statins and the risk of cirrhosis. Relevant studies were identified by searching PubMed, EMBASE, and ISI Web of Science for articles published before April 2017. The Newcastle-Ottawa Scale was used to evaluate the quality of the included studies. Six cohort studies, including 38951 cases of cirrhosis in 263573 patients with hepatitis B or C, were identified to investigate the relationship between statins and the risk of cirrhosis. The Newcastle-Ottawa Scale scores for the included studies ranged from 6 to 9, with four high-quality studies and only two of medium quality. The use of statins was associated with a significant 42% reduction in the risk of cirrhosis, without obvious heterogeneity. In addition, this protective effect was more obvious in Asian countries. Moreover, dose-response analysis suggested each additional 50 cumulative defined daily doses (cDDD) of statins decreases the risk of cirrhosis by 11% (odds ratio [OR] = 0.89, 95% confidence interval [CI] = 0.86-0.93, p = 0.001). In summary, statin use is associated with a decreased incidence rate of cirrhosis and is most pronounced in Eastern countries but also in Western countries.
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Affiliation(s)
- Yaqin Wang
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jianping Xiong
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Meng Niu
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaowei Chen
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Long Gao
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Qirun Wu
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Kechuang Zheng
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ke Xu
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
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Ren L, Guo P, Sun QM, Liu H, Chen Y, Huang Y, Cai XJ. Number of parity and the risk of rheumatoid arthritis in women: A dose-response meta-analysis of observational studies. J Obstet Gynaecol Res 2017; 43:1428-1440. [PMID: 28613016 DOI: 10.1111/jog.13370] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 03/10/2017] [Accepted: 04/02/2017] [Indexed: 01/16/2023]
Abstract
AIM The association between parity and rheumatoid arthritis (RA) risk has been investigated, but results are controversial. Thus, our aim was to systematically analyze the effect of number of parity on the risk of RA in women. METHODS Relevant published studies were identified using PubMed and embase databases through 1 April 2016. We pooled the relative risks (RR) and 95% confidence intervals (CI) using random-effects models. RESULTS In all, 12 studies with a total of 2 497 580 participants and 11 521 RA cases were included. A borderline significant inverse association was observed when we compared parity with nulliparity for RA, with summarized RR = 0.90 (95%CI: 0.79-1.02; I2 = 58.5%, Pheterogeneity = 0.010). In dose-response analysis, we observed a significant nonlinear (Pnonlinearity = 0.000) relation between parity number and the risk of RA. Compared with null parity, the pooled RR of RA were 0.89 (95%CI: 0.86-0.93), 0.84 (95%CI: 0.79-0.89), 0.85 (95%CI: 0.79-0.90), 0.88 (95%CI: 0.81-0.95), 0.90 (95%CI: 0.83-0.97), 0.92 (95%CI: 0.84-1.02), and 0.94 (95%CI: 0.83-1.07) for 1, 2, 3, 4, 5, 6, and 7 live births, respectively. Subgroup and sensitivity analyses showed similar associations. No publication bias was found. CONCLUSION The findings from the current meta-analysis indicate that parity was related to decreased risk of RA. The greatest risk reduction appeared when the parity number reached two. Further studies are warranted to confirm our findings.
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Affiliation(s)
- Lei Ren
- Department of Spinal Surgery, Third Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, China
| | - Peng Guo
- Department of Hepatobiliary Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Qiao-Mei Sun
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, China.,School of Graduate Studies, Zunyi Medical University, Zunyi, China
| | - Hong Liu
- Department of Neurology, Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, China
| | - Yu Chen
- Department of Joint Surgery, Third Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, China
| | - Ying Huang
- Department of Respiration, Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xiao-Jun Cai
- Department of Spinal Surgery, Third Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, China
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Xiong J, Lin J, Wang A, Wang Y, Zheng Y, Sang X, Xu Y, Lu X, Zhao H. Tea consumption and the risk of biliary tract cancer: a systematic review and dose-response meta-analysis of observational studies. Oncotarget 2017; 8:39649-39657. [PMID: 28454105 PMCID: PMC5503640 DOI: 10.18632/oncotarget.16963] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/29/2017] [Indexed: 01/11/2023] Open
Abstract
Recent studies have shown that tea consumption is associated with the reduced incidence of some types of cancer, possibly including biliary tract cancer. However, the epidemiological evidences for the association with risk of biliary tract cancer are contradictory. Thus, we performed meta-analysis of published observational studies to assess the association between tea consumption and risk of biliary tract cancer. Relevant studies were identified by searching PubMed, EMBASE, and ISI Web of Science published before October 2016. The Newcastle-Ottawa Scale was used to evaluate the quality of included studies, and publication bias was evaluated using funnel plots, and Begg's and Egger's tests. This meta-analysis includes eight studies comprising 18 independent reports. The incidence of biliary tract cancer reduced about 34% (significantly) for tea intake group in comparison with never intake group (summary odds ratio [OR] = 0.66; 95% confidence interval [CI] = 0.48-0.85). Additionally, an inverse relationship between tea intake and risk of biliary tract cancer was statistically significant in women (OR = 0.65; 95 % CI = 0.47-0.83), but not in men (OR = 0.86; 95% CI = 0.58-1.13). Dose- response analysis indicated that the risk of biliary tract cancer decreased by 4% with each additional cup of tea one day (relative risk [RR] = 0.96, 95% CI = 0.93-0.98, p = 0.001). In summary, tea intake is associated with decreased risk of biliary tract cancer, especially for women.
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Affiliation(s)
- Jianping Xiong
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianzhen Lin
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Anqiang Wang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yaqin Wang
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ying Zheng
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Science, University of Macau, Macau SAR, China
| | - Xinting Sang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiyao Xu
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Lu
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haitao Zhao
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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10
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Does alcohol consumption modify the risk of endometrial cancer? A dose-response meta-analysis of prospective studies. Arch Gynecol Obstet 2016; 295:467-479. [PMID: 27975130 DOI: 10.1007/s00404-016-4263-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 12/02/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Epidemiological studies have provided controversial evidence of an association between alcohol intake and endometrial cancer (EC) risk. The World Cancer Research Fund/American Institute for Cancer Research classifies alcohol as having a "limited-no conclusion" grade of evidence in the Endometrial Cancer 2013 Report (the latest version). OBJECTIVE The purpose of this meta-analysis is to systematically analyze the effect of alcohol intake on EC risk. METHODS We conducted a dose-response meta-analysis of prospective cohort studies identified from the PubMed, Embase, Cochrane Library and China Biological Medicine databases. Categorical and dose-response meta-analyses were conducted to estimate the effects of alcohol on EC risk. RESULTS A total of 10 studies involving 9766 cases and 1,612,798 participants were included in this meta-analysis. Overall, the relative risk(RR) for alcohol intake on EC was 1.04 (95% CI 0.88-1.22). The RRs for alcohol intake from wine, beer, and liquor were 1.10 (95% CI 0.80-1.51), 0.94 (95% CI 0.72-1.22), and 1.04 (95% CI 0.86-1.27), respectively). When alcohol consumption was stratified by drinking level, the RRs for moderate and heavy alcohol intake were 0.95 (95% CI 0.89-1.01) and 1.00 (95% CI 0.88-1.13), respectively. In the subgroup analyses, this association was not modified by other lifestyle factors or the characteristics of the study design and population. No significant associations were detected in the dose-response meta-analyses. CONCLUSIONS Alcohol intake is not associated with EC regardless of the beverage choice and alcohol consumption level. More studies are warranted in other populations, such as Asians and Africans.
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Guo P, Huang G, Ren L, Chen Y, Zhou Q. Number of parity and the risk of non-Hodgkin lymphomas: a dose-response meta-analysis of observational studies. ACTA ACUST UNITED AC 2016; 22:274-285. [PMID: 27832724 DOI: 10.1080/10245332.2016.1252002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Epidemiological reports have shown that parity is associated with a risk of developing non-Hodgkin lymphomas (NHL). However, the findings have been inconsistent. METHODS We searched the EMBASE and PubMed databases for eligible studies up to 10 March 2016. Category and generalized least square regression models were used to perform data analyses. RESULTS In total, five cohort and seven case-control studies were identified. Categorical analyses indicated that parity number has little association with NHL and its subtypes. In dose-risk analyses, there were no relationships between parity and NHL risk (pfor association = 0.064; n = 10). The summarized risk ratio (RR) was 0.97 (95% confidence interval (CI): 0.95-1.00; I2 = 57.8%; pheterogeneity = 0.014; Power = 0.79) for each additional live birth increase. Similarly, for B-cell NHL, there was a null association between parity and NHL risk (pfor association = 0.121; n = 5). The combined RR was 0.96 (95% CI = 0.90-1.03; I2 = 63.7%; pheterogeneity = 0.026; Power = 0.71) for each additional live birth. For follicular NHL, there was still a non-significant association identified (pfor association = 0.071; n = 4), the pooled RR was 1.00 (95% CI = 0.95-1.07; I2 = 17.3%; pheterogeneity = 0.305; Power = 0.26) per additional live birth. CONCLUSIONS Our data identified little evidence suggesting that high parity is a protective factor against the development of NHL, including its B-cell and follicular subtypes.
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Affiliation(s)
- Peng Guo
- a Department of Hepatobiliary Surgery , Renmin Hospital, Hubei University of Medicine , Shiyan , Hubei , China
| | - GuiChuan Huang
- b Department of Respiration , The Third Affiliated Hospital of Zunyi Medical University , Zunyi , China
| | - Lei Ren
- c Department of Spinal Surgery , The Third Affiliated Hospital of Zunyi Medical University , Zunyi , China
| | - Yu Chen
- d Department of Joint Surgery , Affiliated Hospital of Zunyi Medical University, Zunyi Medical University , Zunyi , China
| | - Quan Zhou
- e Department of Science and Education , The First People's Hospital of Changde City , Changde , Hunan , China
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