Table 1.

Characteristics of observational studies addressing the association of gastric cancer with menstrual and reproductive factors, and with use of estrogen-related therapies

Authors, year (reference)Country in which conductedExposure(s) studiedType of studyCases/controls (overall follow-up time)Comparison groupAge range (menopausal status)Histologic type of casesAnatomic site of casesConfounders controlled
La Vecchia and colleagues 1994 (26)ItalyAge at menopause, age at menarche, years of fertility, parity, age at first birth, OC use, HRT use, history of spontaneous and induced abortions.Case–control229/614Hospital-based controls35–79 (all postmenopausal)No dataNo dataAge, education, area of residence, family history of gastric cancer, total calories, beta-carotene and vitamin C intake, and other hormone-related exposure variables
Palli and colleagues 1994 (27)ItalyAge at menopausea, age at menarche, years of fertilitya, parity, age at first birth, number of spontaneous/induced abortions.Case–control339/515Population-based controls<75 (all postmenopausal)No dataNo dataAge, geographic area, place of residence, migration from the south, SES, family history of gastric cancer, BMI, total caloric intake and protein and ascorbic acid intake.
Heuch andcolleagues 2000 (29) and Heuch and colleagues 2003 (33)NorwayAge at menopause, age at menarche, parity, age at first birth, number of abortions and duration of breastfeeding.Cohort572/∼ 62,518 (1,442,514 p-y)Participants in a screening program for breast cancer (1956–1959)32–79 (pre and postmenopausal)No dataCardia and fundus:58; corpus: 58; antrum and pylorus: 180; unspecified: 276Age, birth cohort, area of residency and county. Parity and age at delivery were included in some models.
Inoue and colleagues 2002 (30)JapanAge at menopause, age at menarche, menstrual irregularity, years of fertility, pregnancy, parity, age at first birth, number of children breastfed and duration of breastfeedinga.Case–control365/1,825Hospital-based controls39–82 (all post-menopausal)Differentiated: 133; undifferentiated: 232.Upper third:72; middle third: 155; lower third: 127.Age, year and season of interview, family history of gastric cancer, smoking status and raw vegetable and cooked fish intake.
Kaneko and colleagues 2003 (31)JapanAge at menopause, age at menarche, years of fertility, parity, age at first pregnancy, HRT use.Cohort156/∼ 40,379 (330,786 p-y)Participants in the JACC40–79 (all postmenopausal)No dataNo dataAge.
Fernandez and colleagues 2003 (32)ItalyHRT use.Case–control258/6,976Hospital-based controls45–79No dataNo dataAge, study center, year of interview, education, smoking, drinking, type of menopause, age at menopause and BMI.
Frise and colleagues 2006 (35)CanadaAge at menopause, menopausal status, age at menarchea, years of fertility, parity, age at first pregnancy, OC use, use and duration of HRT, history of hysterectomy or oophorectomy.Case–control326/326Population-based controls20–74 (pre and postmenopausal)Intestinal: 55;diffuse: 106; mixed: 15; unknown: 150.Proximal: 49; distal: 176; overlapping: 13; unknown: 88.Age, education, meat consumption, and other hormone-related exposure variables.
Freedman and colleagues 2007 (36)ChinaAge at menopausea, menopausal status, age at menarche, years of fertilitya, years since menopause, pregnancies, parity, age at first pregnancy, oral and injectable contraceptives use, IUD usea, HRT use, history of hysterectomya or ovariectomya, duration of breastfeeding.Cohort154/∼73,288 (419,260 p-y)Participants in the Shanghai Women's Health Study40–70 (pre andpostmenopausal)No dataNo dataAge, BMI, education, income, cigarette smoking status, and smoking dose.
Sakauchi, 2007 (37)JapanAge at menopause, age at menarche, type of menopause, years of fertility, pregnancies, parity, age at first delivery, use and duration of HRT.Cohort386/no data (∼750,619 p-y)Participants in the JACCall postmenopausalNo dataNo dataAge and area of study.
Persson and colleagues 2008 (38)JapanAge at menopause, age at menarche, years of fertility, menstruation status menopause status, regularity of menstruation, age at first delivery, age at first pregnancy, pregnancies, number of deliveries, any hormone intake, breast-feeding, history of endometritis or vaginitis.Cohort368/∼ 44,085(541,862 p-y)Participants in the JPHC40–69 (pre and postmenopausal)Differentiated: 97; undifferentiated: 242, unclassified: 29.Proximal: 26, distal: 265, overlapping: 11, unspecified: 66.Age, family history of gastric cancer, and study area.
Bahmanyar and colleagues 2008 (39)SwedenAge at first birth and parity.Nested case–control2,498/12,490Participants in a cohort of women born in 1925 or later≥30 (pre and postmenopausal)No dataNoncardia: 2,498Year of birth, occupational class, education level, age at first birth and parity.
Dorjgochoo and colleagues 2009 (40)ChinaOC use, IDU use, tubal sterilization.Cohort168/∼ 66,493Participants in the Shanghai Women's Health Study40–70 (pre- and postmenopausal)No dataNo dataAge, education, age at menarche, number of live births, cumulative breast feeding months, BMI, exercised regularly in past 5 years, smoking, menopausal status, first-degree family history of cancer and other contraceptive methods
Freedman andcolleagues 2010 (41)United StatesAge at menopause, age at menarche, parity, age at first birth, history of hysterectomy or oophorectomy, duration of OC use, use and duration of HRT.Cohort97/∼ 201,409Participants in the NIH-AARP Diet and Health Study50–71 (pre and postmenopausal)No dataNoncardia: 97Age, BMI, fruit and vegetable consumption, smoking use, alcohol intake, physical activity, and total energy intake.
Duell and colleagues 2010 (11)European countriesAge at menarche and menopause, duration of OC use, HRT use, parity, age at first full-term pregnancy, breastfeeding, miscarriage, induced abortion, ovariectomy, hysterectomy, and cumulative duration of menstrual cycling.Cohort181/∼ 335,035 (2,927,994 p-y)Participants in the EPIC35–70 (pre and postmenopausal)Intestinal: 48;diffuse: 82; mixed/unclassified/unknown: 53Noncardia: 101; cardia: 31; overlapping/unknown: 49Age, center, smoking status, education, BMI, and calorie-adjusted vegetable, fruit, red meat, and processed meat intakes.
Chung and colleagues 2011 (42)KoreaAge at menarche, age at first pregnancy, parity, history of lactation, and OC use.Case–control1,495/1,350Hospital-based controls18–45 (Pre- and postmenopausal)No dataNo dataAge.
Chang and colleagues 2011 (43)TaiwanParityCohort1,090/∼1,291,372 (33,686,828 p-y)Participants in a cohort of women with a record of a first and singleton childbirth in the Birth Registry between 1978 to 1987(Pre and postmenopausal)No dataNo dataAge, marital status, years of schooling and birthplace.
Green and colleagues 2011 (44)United KingdomHRT use.Nested case–control750/3,722Participants in the GPRD50–84 (all postmenopausal)No dataNo dataAge, calendar time and length of observation in GPRD, tobacco smoking, alcohol consumption, and BMI.

Abbreviations: JAAC, Japan Collaborative Cohort Study; JPHC, Japan Public Health Center-based Prospective Study; EPIC, European Prospective Investigation into Cancer and Nutrition; BMI, body mass index; GPRD, UK General Research Database.

  • aStatistically significant result.