Reproductive and menstrual factors and colorectal cancer incidence in the Women's Health Initiative Observational Study

Neil Murphy, Linzhi Xu, Alice Zervoudakis, Xiaonan (Nan) Xue, Geoffrey Kabat, Thomas E. Rohan, Sylvia Wassertheil-Smoller, Mary Jo O'Sullivan, Cynthia Thomson, Catherine Messina, Howard Strickler, Marc J. Gunter

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Abstract

Background:Reproductive and menstrual factors have been evaluated as surrogates for long-term hormonal exposures in several prospective studies of colorectal cancer, yet findings have been conflicting.Methods:The relation of reproductive and menstrual factors (self-reported via a reproductive history questionnaire) with incident colorectal cancer was investigated among women enrolled in the Women's Health Initiative Observational Study (WHI-OS), a longitudinal cohort of 93 676 postmenopausal women (aged 50-79 years at enrolment) in which 1149 incident cases of colorectal cancer occurred over a median follow-up of 11.9 years. Multivariable Cox proportional hazards models that included established colorectal cancer risk factors were constructed to examine the association of colorectal cancer incidence with reproductive and menstrual factors.Results:Having had two children (vs nulliparous: hazard ratio (HR)=0.80, 95% confidence interval (CI): 0.64-0.99) was inversely associated with colorectal cancer risk. Compared with never users, ever use of oral contraceptives was associated with lower colorectal cancer risk (HR=0.74, 95% CI: 0.63-0.86); however, no relationship was observed for duration of oral contraceptives use (4 years vs 1 year: HR=0.94, 95% CI: 0.67-1.32). None of the remaining reproductive and menstrual factors was associated with colorectal cancer incidence.Conclusions:Parity and prior use of oral contraceptives were associated with lower colorectal cancer risk in this cohort of postmenopausal women.

Original languageEnglish (US)
Pages (from-to)117-125
Number of pages9
JournalBritish Journal of Cancer
Volume116
Issue number1
DOIs
StatePublished - Jan 3 2017

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Women's Health
Observational Studies
Colorectal Neoplasms
Incidence
Oral Contraceptives
Confidence Intervals
Reproductive History
Parity
Proportional Hazards Models
Odds Ratio
Prospective Studies

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Reproductive and menstrual factors and colorectal cancer incidence in the Women's Health Initiative Observational Study. / Murphy, Neil; Xu, Linzhi; Zervoudakis, Alice; Xue, Xiaonan (Nan); Kabat, Geoffrey; Rohan, Thomas E.; Wassertheil-Smoller, Sylvia; O'Sullivan, Mary Jo; Thomson, Cynthia; Messina, Catherine; Strickler, Howard; Gunter, Marc J.

In: British Journal of Cancer, Vol. 116, No. 1, 03.01.2017, p. 117-125.

Research output: Contribution to journalArticle

Murphy, N, Xu, L, Zervoudakis, A, Xue, XN, Kabat, G, Rohan, TE, Wassertheil-Smoller, S, O'Sullivan, MJ, Thomson, C, Messina, C, Strickler, H & Gunter, MJ 2017, 'Reproductive and menstrual factors and colorectal cancer incidence in the Women's Health Initiative Observational Study', British Journal of Cancer, vol. 116, no. 1, pp. 117-125. https://doi.org/10.1038/bjc.2016.345
Murphy, Neil ; Xu, Linzhi ; Zervoudakis, Alice ; Xue, Xiaonan (Nan) ; Kabat, Geoffrey ; Rohan, Thomas E. ; Wassertheil-Smoller, Sylvia ; O'Sullivan, Mary Jo ; Thomson, Cynthia ; Messina, Catherine ; Strickler, Howard ; Gunter, Marc J. / Reproductive and menstrual factors and colorectal cancer incidence in the Women's Health Initiative Observational Study. In: British Journal of Cancer. 2017 ; Vol. 116, No. 1. pp. 117-125.
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AU - Rohan, Thomas E.

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AU - Strickler, Howard

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