Association of female reproductive and hormonal factors with gallbladder cancer risk in Asia: A pooled analysis of the Asia Cohort Consortium

Author:

Shin Aesun1234ORCID,Cho Sooyoung14,Abe Sarah Krull5ORCID,Islam Md Rashedul56,Rahman Md Shafiur57,Saito Eiko8ORCID,Kazmi Sayada Zartasha1ORCID,Katagiri Ryoko910ORCID,Merritt Melissa11,Choi Ji‐Yeob12ORCID,Shu Xiao‐Ou13ORCID,Sawada Norie9ORCID,Tamakoshi Akiko14,Koh Woon‐Puay1516,Sakata Ritsu17,Hozawa Atsushi18,Kim Jeongseon19ORCID,Park Sue K.123ORCID,Kweon Sun‐Seog20,Wen Wanqing13,Tsugane Shoichiro921,Kimura Takashi14,Yuan Jian‐Min2223ORCID,Kanemura Seiki18,Sugawara Yumi18ORCID,Shin Min‐Ho20,Ahsan Habibul24,Boffetta Paolo2526,Chia Kee Seng27,Matsuo Keitaro2829ORCID,Qiao You‐Lin30ORCID,Rothman Nathaniel31ORCID,Zheng Wei13ORCID,Inoue Manami5ORCID,Kang Daehee13ORCID

Affiliation:

1. Department of Preventive Medicine Seoul National University College of Medicine Seoul Republic of Korea

2. Cancer Research Institute Seoul National University Seoul Republic of Korea

3. Integrated Major in Innovative Medical Science Seoul National University College of Medicine Seoul Republic of Korea

4. Medical Research Centre, Genomic Medicine Institute Seoul National University College of Medicine Seoul Republic of Korea

5. Division of Prevention, Centre for Public Health Sciences, National Cancer Centre Institute for Cancer Control Tokyo Japan

6. Hitotsubashi Institute for Advanced Study Hitotsubashi University Tokyo Japan

7. Research Centre for Child Mental Development Hamamatsu University School of Medicine Hamamatsu Japan

8. Sustainable Society Design Center Graduate School of Frontier Science, The University of Tokyo Tokyo Japan

9. Division of Cohort Research National Cancer Centre, Institute for Cancer Control Tokyo Japan

10. National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition Osaka Japan

11. The Daffodil Centre The University of Sydney, a joint venture with Cancer Council NSW Sydney New South Wales Australia

12. Department of Biomedical Sciences Seoul National University Graduate School Seoul Republic of Korea

13. Division of Epidemiology, Vanderbilt‐Ingram Cancer Centre, Vanderbilt Epidemiology Centre Vanderbilt University Medical Centre Nashville Tennessee USA

14. Department of Public Health Hokkaido University Faculty of Medicine Sapporo Japan

15. Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore

16. Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR) Singapore Singapore

17. Radiation Effects Research Foundation Hiroshima Japan

18. Tohoku University Graduate School of Medicine Miyagi Prefecture Japan

19. Graduate School of Cancer Science and Policy, National Cancer Centre Gyeonggi‐do Republic of Korea

20. Department of Preventive Medicine Chonnam National University Medical School Gwangju Republic of Korea

21. Graduate School of Public Health International University of Health and Welfare Tokyo Japan

22. Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Centre University of Pittsburgh Pittsburgh Pennsylvania USA

23. Department of Epidemiology, Graduate School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA

24. Department of Public Health Sciences University of Chicago Chicago Illinois USA

25. Stony Brook Cancer Centre Stony Brook University Stony Brook New York USA

26. Department of Medical and Surgical Sciences University of Bologna Bologna Italy

27. Saw Swee Hock School of Public Health National University of Singapore Singapore

28. Division of Cancer Epidemiology and Prevention Aichi Cancer Centre Research Institute Nagoya Japan

29. Department of Cancer Epidemiology Nagoya University Graduate School of Medicine Nagoya Japan

30. School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

31. Division of Cancer Epidemiology & Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute Bethesda Maryland USA

Abstract

AbstractThe female predominance of gallbladder cancer (GBC) has led to a hypothesis regarding the hormone‐related aetiology of GBC. We aimed to investigate the association between female reproductive factors and GBC risk, considering birth cohorts of Asian women. We conducted a pooled analysis of 331,323 women from 12 cohorts across 4 countries (China, Japan, Korea, and Singapore) in the Asia Cohort Consortium. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) to assess the association between reproductive factors (age at menarche, parity, age at first delivery, breastfeeding, and age at menopause) and GBC risk. We observed that a later age at menarche was associated with an increased risk of GBC (HR 1.4, 95% CI 1.16–1.70 for 17 years and older vs. 13–14 years), especially among the cohort born in 1940 and later (HR 2.5, 95% CI 1.50–4.35). Among the cohort born before 1940, women with a later age at first delivery showed an increased risk of GBC (HR 1.56, 95% CI 1.08–2.24 for 31 years of age and older vs. 20 years of age and younger). Other reproductive factors did not show a clear association with GBC risk. Later ages at menarche and at first delivery were associated with a higher risk of GBC, and these associations varied by birth cohort.

Funder

National Research Foundation of Korea

Ministry of Health, Labour and Welfare

U.S. Department of Energy

Publisher

Wiley

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