Abstract
Background Menarche and menopause mark the onset and cessation, respectively, of ovarian activity associated with reproduction, and affect breast cancer risk. Our aim was to assess the strengths of their effects and determine whether they depend on characteristics of the tumours or the affected women. Methods Individual data from 117 epidemiological studies, including 118 964 women with invasive breast cancer and 306 091 without the disease, none of whom had used menopausal hormone therapy, were included in the analyses. We calculated adjusted relative risks (RRs) associated with menarche and menopause for breast cancer overall, and by tumour histology and by oestrogen receptor expression. Findings Breast cancer risk increased by a factor of 1.050 (95% CI 1.044-1.057; p<0.0001) for every year younger at menarche, and independently by a smaller amount (1.029, 1.025-1.032; p<0.0001), for every year older at menopause. Premenopausal women had a greater risk of breast cancer than postmenopausal women of an identical age (RR at age 45-54 years 1.43, 1.33-1.52, p<0.001). All three of these associations were attenuated by increasing adiposity among postmenopausal women, but did not vary materially by women's year of birth, ethnic origin, childbearing history, smoking, alcohol consumption, or hormonal contraceptive use. All three associations were stronger for lobular than for ductal tumours (p<0.006 for each comparison). The effect of menopause in women of an identical age and trends by age at menopause were stronger for oestrogen receptor-positive disease than for oestrogen receptor-negative disease (p<0.01 for both comparisons). Interpretation The effects of menarche and menopause on breast cancer risk might not be acting merely by lengthening women's total number of reproductive years. Endogenous ovarian hormones are more relevant for oestrogen receptorpositive disease than for oestrogen receptor-negative disease and for lobular than for ductal tumours.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1141-1151 |
| Number of pages | 11 |
| Journal | The Lancet Oncology |
| Volume | 13 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2012 |
ASJC Scopus subject areas
- Oncology
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Menarche, menopause, and breast cancer risk : Individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. / Hamajima, N.; Hirose, K.; Tajima, K.; Rohan, T.; Friedenreich, C. M.; Calle, E. E.; Gapstur, S. M.; Patel, A. V.; Coates, R. J.; Liff, J. M.; Talamini, R.; Chantarakul, N.; Koetsawang, S.; Rachawat, D.; Marcou, Y.; Kakouri, E.; Duffy, S. W.; Morabia, A.; Schuman, L.; Stewart, W.; Szklo, M.; Coogan, P. F.; Palmer, J. R.; Rosenberg, L.; Band, P.; Coldman, A. J.; Gallagher, R. P.; Hislop, T. G.; Yang, P.; Cummings, S. R.; Canfell, K.; Sitas, F.; Chao, P.; Lissowska, J.; Horn-Ross, P. L.; John, E. M.; Kolonel, L. M.; Nomura, A. M.Y.; Ghiasvand, R.; Hu, J.; Johnson, K. C.; Mao, Y.; Beral, V.; Bull, D.; Callaghan, K.; Crossley, B.; Goodill, A.; Green, J.; Hermon, C.; Key, T.; Lindgard, I.; Liu, B.; Pirie, K.; Reeves, G.; Collins, R.; Doll, R.; Peto, R.; Bishop, T.; Fentiman, I. S.; De Sanjosé, S.; Gonzalez, C. A.; Lee, N.; Marchbanks, P.; Ory, H. W.; Peterson, H. B.; Wingo, P.; Ebeling, K.; Kunde, D.; Nishan, P.; Hopper, J. L.; Eliassen, H.; Hankinson, S.; Gajalakshmi, V.; Martin, N.; Pardthaisong, T.; Silpisornkosol, S.; Theetranont, C.; Boosiri, B.; Chutivongse, S.; Jimakorn, P.; Virutamasen, P.; Wongsrichanalai, C.; Neugut, A.; Santella, R.; Baines, C. J.; Kreiger, N.; Miller, A. B.; Wall, C.; Tjonneland, A.; Jorgensen, T.; Stahlberg, C.; Pedersen, A. Tønnes; Flesch-Janys, D.; Hakansson, N.; Cauley, J.; Heuch, I.; Adami, H. O.; Persson, I.; Weiderpass, E.; Magnusson, C.; Chang-Claude, J.; Kaaks, R.; McCredie, M.; Paul, C.; Skegg, D. C.G.; Spears, G. F.S.; Iwasaki, M.; Tsugane, S.; Anderson, G.; Daling, J. R.; Hampton, J.; Hutchinson, W. B.; Li, C. I.; Malone, K.; Mandelson, M.; Newcomb, P.; Noonan, E. A.; Ray, R. M.; Stanford, J. L.; Tang, M. T.C.; Thomas, D. B.; Weiss, N. S.; White, E.; Izquierdo, A.; Viladiu, P.; Fourkala, E. O.; Jacobs, I.; Menon, U.; Ryan, A.; Cuevas, H. R.; Ontiveros, P.; Palet, A.; Salazar, S. B.; Aristizabal, N.; Cuadros, A.; Tryggvadottir, L.; Tulinius, H.; Riboli, E.; Andrieu, N.; Bachelot, A.; Lê, M. G.; Brêmond, A.; Gairard, B.; Lansac, J.; Piana, L.; Renaud, R.; Clavel-Chapelon, F.; Fournier, A.; Touillaud, M.; Mesrine, S.; Chabbert-Buffet, N.; Boutron-Ruault, M. C.; Wolk, A.; Torres-Mejia, G.; Franceschi, S.; Romieu, I.; Boyle, P.; Lubin, F.; Modan, B.; Ron, E.; Wax, Y.; Friedman, G. D.; Hiatt, R. A.; Levi, F.; Kosmelj, K.; Primic-Zakelj, M.; Ravnihar, B.; Stare, J.; Ekbom, A.; Erlandsson, G.; Persson, I.; Beeson, W. L.; Fraser, G.; Peto, J.; Hanson, R. L.; Leske, M. C.; Mahoney, M. C.; Nasca, P. C.; Varma, A. O.; Weinstein, A. L.; Hartman, M. L.; Olsson, H.; Goldbohm, R. A.; van den Brandt, P. A.; Palli, D.; Teitelbaum, S.; Apelo, R. A.; Baens, J.; de la Cruz, J. R.; Javier, B.; Lacaya, L. B.; Ngelangel, C. A.; La Vecchia, C.; Negri, E.; Marubini, E.; Ferraroni, M.; Pike, M. C.; Gerber, M.; Richardson, S.; Segala, C.; Gatei, D.; Kenya, P.; Kungu, A.; Mati, J. G.; Brinton, L. A.; Freedman, M.; Hoover, R.; Schairer, C.; Ziegler, R.; Banks, E.; Spirtas, R.; Lee, H. P.; Rookus, M. A.; van Leeuwen, F. E.; Schoenberg, J. A.; Graff-Iversen, S.; Selmer, R.; Jones, L.; McPherson, K.; Neil, A.; Vessey, M.; Yeates, D.; Mabuchi, K.; Preston, D.; Hannaford, P.; Kay, C.; McCann, S. E.; Rosero-Bixby, L.; Gao, Y. T.; Jin, F.; Yuan, J. M.; Wei, H. Y.; Yun, T.; Zhiheng, C.; Berry, G.; Booth, J. C.; Jelihovsky, T.; MacLennan, R.; Shearman, R.; Hadjisavvas, A.; Kyriacou, K.; Loisidou, M.; Zhou, X.; Wang, Q. S.; Kawai, M.; Minami, Y.; Tsuji, I.; Lund, E.; Kumle, M.; Stalsberg, H.; Shu, X. O.; Zheng, W.; Monninkhof, E. M.; Onland-Moret, N. C.; Peeters, P. H.M.; Katsouyanni, K.; Trichopoulou, A.; Trichopoulos, D.; Tzonou, A.; Baltzell, K. A.; Dabancens, A.; Martinez, L.; Molina, R.; Salas, O.; Alexander, F. E.; Anderson, K.; Folsom, A. R.; Gammon, M. D.; Hulka, B. S.; Millikan, R.; Chilvers, C. E.D.; Lumachi, F.; Bain, C.; Schofield, F.; Siskind, V.; Rebbeck, T. R.; Bernstein, L. R.; Enger, S.; Haile, R. W.; Paganini-Hill, A.; Ross, R. K.; Ursin, G.; Wu, A. H.; Yu, M. C.; Ewertz, M.; Clarke, E. A.; Bergkvist, L.; Anderson, G. L.; Gass, M.; O'Sullivan, M. J.; Kalache, A.; Farley, T. M.M.; Holck, S.; Meirik, O.; Fukao, A.
In: The Lancet Oncology, Vol. 13, No. 11, 11.2012, p. 1141-1151.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Menarche, menopause, and breast cancer risk
T2 - Individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies
AU - Hamajima, N.
AU - Hirose, K.
AU - Tajima, K.
AU - Rohan, T.
AU - Friedenreich, C. M.
AU - Calle, E. E.
AU - Gapstur, S. M.
AU - Patel, A. V.
AU - Coates, R. J.
AU - Liff, J. M.
AU - Talamini, R.
AU - Chantarakul, N.
AU - Koetsawang, S.
AU - Rachawat, D.
AU - Marcou, Y.
AU - Kakouri, E.
AU - Duffy, S. W.
AU - Morabia, A.
AU - Schuman, L.
AU - Stewart, W.
AU - Szklo, M.
AU - Coogan, P. F.
AU - Palmer, J. R.
AU - Rosenberg, L.
AU - Band, P.
AU - Coldman, A. J.
AU - Gallagher, R. P.
AU - Hislop, T. G.
AU - Yang, P.
AU - Cummings, S. R.
AU - Canfell, K.
AU - Sitas, F.
AU - Chao, P.
AU - Lissowska, J.
AU - Horn-Ross, P. L.
AU - John, E. M.
AU - Kolonel, L. M.
AU - Nomura, A. M.Y.
AU - Ghiasvand, R.
AU - Hu, J.
AU - Johnson, K. C.
AU - Mao, Y.
AU - Beral, V.
AU - Bull, D.
AU - Callaghan, K.
AU - Crossley, B.
AU - Goodill, A.
AU - Green, J.
AU - Hermon, C.
AU - Key, T.
AU - Lindgard, I.
AU - Liu, B.
AU - Pirie, K.
AU - Reeves, G.
AU - Collins, R.
AU - Doll, R.
AU - Peto, R.
AU - Bishop, T.
AU - Fentiman, I. S.
AU - De Sanjosé, S.
AU - Gonzalez, C. A.
AU - Lee, N.
AU - Marchbanks, P.
AU - Ory, H. W.
AU - Peterson, H. B.
AU - Wingo, P.
AU - Ebeling, K.
AU - Kunde, D.
AU - Nishan, P.
AU - Hopper, J. L.
AU - Eliassen, H.
AU - Hankinson, S.
AU - Gajalakshmi, V.
AU - Martin, N.
AU - Pardthaisong, T.
AU - Silpisornkosol, S.
AU - Theetranont, C.
AU - Boosiri, B.
AU - Chutivongse, S.
AU - Jimakorn, P.
AU - Virutamasen, P.
AU - Wongsrichanalai, C.
AU - Neugut, A.
AU - Santella, R.
AU - Baines, C. J.
AU - Kreiger, N.
AU - Miller, A. B.
AU - Wall, C.
AU - Tjonneland, A.
AU - Jorgensen, T.
AU - Stahlberg, C.
AU - Pedersen, A. Tønnes
AU - Flesch-Janys, D.
AU - Hakansson, N.
AU - Cauley, J.
AU - Heuch, I.
AU - Adami, H. O.
AU - Persson, I.
AU - Weiderpass, E.
AU - Magnusson, C.
AU - Chang-Claude, J.
AU - Kaaks, R.
AU - McCredie, M.
AU - Paul, C.
AU - Skegg, D. C.G.
AU - Spears, G. F.S.
AU - Iwasaki, M.
AU - Tsugane, S.
AU - Anderson, G.
AU - Daling, J. R.
AU - Hampton, J.
AU - Hutchinson, W. B.
AU - Li, C. I.
AU - Malone, K.
AU - Mandelson, M.
AU - Newcomb, P.
AU - Noonan, E. A.
AU - Ray, R. M.
AU - Stanford, J. L.
AU - Tang, M. T.C.
AU - Thomas, D. B.
AU - Weiss, N. S.
AU - White, E.
AU - Izquierdo, A.
AU - Viladiu, P.
AU - Fourkala, E. O.
AU - Jacobs, I.
AU - Menon, U.
AU - Ryan, A.
AU - Cuevas, H. R.
AU - Ontiveros, P.
AU - Palet, A.
AU - Salazar, S. B.
AU - Aristizabal, N.
AU - Cuadros, A.
AU - Tryggvadottir, L.
AU - Tulinius, H.
AU - Riboli, E.
AU - Andrieu, N.
AU - Bachelot, A.
AU - Lê, M. G.
AU - Brêmond, A.
AU - Gairard, B.
AU - Lansac, J.
AU - Piana, L.
AU - Renaud, R.
AU - Clavel-Chapelon, F.
AU - Fournier, A.
AU - Touillaud, M.
AU - Mesrine, S.
AU - Chabbert-Buffet, N.
AU - Boutron-Ruault, M. C.
AU - Wolk, A.
AU - Torres-Mejia, G.
AU - Franceschi, S.
AU - Romieu, I.
AU - Boyle, P.
AU - Lubin, F.
AU - Modan, B.
AU - Ron, E.
AU - Wax, Y.
AU - Friedman, G. D.
AU - Hiatt, R. A.
AU - Levi, F.
AU - Kosmelj, K.
AU - Primic-Zakelj, M.
AU - Ravnihar, B.
AU - Stare, J.
AU - Ekbom, A.
AU - Erlandsson, G.
AU - Persson, I.
AU - Beeson, W. L.
AU - Fraser, G.
AU - Peto, J.
AU - Hanson, R. L.
AU - Leske, M. C.
AU - Mahoney, M. C.
AU - Nasca, P. C.
AU - Varma, A. O.
AU - Weinstein, A. L.
AU - Hartman, M. L.
AU - Olsson, H.
AU - Goldbohm, R. A.
AU - van den Brandt, P. A.
AU - Palli, D.
AU - Teitelbaum, S.
AU - Apelo, R. A.
AU - Baens, J.
AU - de la Cruz, J. R.
AU - Javier, B.
AU - Lacaya, L. B.
AU - Ngelangel, C. A.
AU - La Vecchia, C.
AU - Negri, E.
AU - Marubini, E.
AU - Ferraroni, M.
AU - Pike, M. C.
AU - Gerber, M.
AU - Richardson, S.
AU - Segala, C.
AU - Gatei, D.
AU - Kenya, P.
AU - Kungu, A.
AU - Mati, J. G.
AU - Brinton, L. A.
AU - Freedman, M.
AU - Hoover, R.
AU - Schairer, C.
AU - Ziegler, R.
AU - Banks, E.
AU - Spirtas, R.
AU - Lee, H. P.
AU - Rookus, M. A.
AU - van Leeuwen, F. E.
AU - Schoenberg, J. A.
AU - Graff-Iversen, S.
AU - Selmer, R.
AU - Jones, L.
AU - McPherson, K.
AU - Neil, A.
AU - Vessey, M.
AU - Yeates, D.
AU - Mabuchi, K.
AU - Preston, D.
AU - Hannaford, P.
AU - Kay, C.
AU - McCann, S. E.
AU - Rosero-Bixby, L.
AU - Gao, Y. T.
AU - Jin, F.
AU - Yuan, J. M.
AU - Wei, H. Y.
AU - Yun, T.
AU - Zhiheng, C.
AU - Berry, G.
AU - Booth, J. C.
AU - Jelihovsky, T.
AU - MacLennan, R.
AU - Shearman, R.
AU - Hadjisavvas, A.
AU - Kyriacou, K.
AU - Loisidou, M.
AU - Zhou, X.
AU - Wang, Q. S.
AU - Kawai, M.
AU - Minami, Y.
AU - Tsuji, I.
AU - Lund, E.
AU - Kumle, M.
AU - Stalsberg, H.
AU - Shu, X. O.
AU - Zheng, W.
AU - Monninkhof, E. M.
AU - Onland-Moret, N. C.
AU - Peeters, P. H.M.
AU - Katsouyanni, K.
AU - Trichopoulou, A.
AU - Trichopoulos, D.
AU - Tzonou, A.
AU - Baltzell, K. A.
AU - Dabancens, A.
AU - Martinez, L.
AU - Molina, R.
AU - Salas, O.
AU - Alexander, F. E.
AU - Anderson, K.
AU - Folsom, A. R.
AU - Gammon, M. D.
AU - Hulka, B. S.
AU - Millikan, R.
AU - Chilvers, C. E.D.
AU - Lumachi, F.
AU - Bain, C.
AU - Schofield, F.
AU - Siskind, V.
AU - Rebbeck, T. R.
AU - Bernstein, L. R.
AU - Enger, S.
AU - Haile, R. W.
AU - Paganini-Hill, A.
AU - Ross, R. K.
AU - Ursin, G.
AU - Wu, A. H.
AU - Yu, M. C.
AU - Ewertz, M.
AU - Clarke, E. A.
AU - Bergkvist, L.
AU - Anderson, G. L.
AU - Gass, M.
AU - O'Sullivan, M. J.
AU - Kalache, A.
AU - Farley, T. M.M.
AU - Holck, S.
AU - Meirik, O.
AU - Fukao, A.
PY - 2012/11
Y1 - 2012/11
N2 - Background Menarche and menopause mark the onset and cessation, respectively, of ovarian activity associated with reproduction, and affect breast cancer risk. Our aim was to assess the strengths of their effects and determine whether they depend on characteristics of the tumours or the affected women. Methods Individual data from 117 epidemiological studies, including 118 964 women with invasive breast cancer and 306 091 without the disease, none of whom had used menopausal hormone therapy, were included in the analyses. We calculated adjusted relative risks (RRs) associated with menarche and menopause for breast cancer overall, and by tumour histology and by oestrogen receptor expression. Findings Breast cancer risk increased by a factor of 1.050 (95% CI 1.044-1.057; p<0.0001) for every year younger at menarche, and independently by a smaller amount (1.029, 1.025-1.032; p<0.0001), for every year older at menopause. Premenopausal women had a greater risk of breast cancer than postmenopausal women of an identical age (RR at age 45-54 years 1.43, 1.33-1.52, p<0.001). All three of these associations were attenuated by increasing adiposity among postmenopausal women, but did not vary materially by women's year of birth, ethnic origin, childbearing history, smoking, alcohol consumption, or hormonal contraceptive use. All three associations were stronger for lobular than for ductal tumours (p<0.006 for each comparison). The effect of menopause in women of an identical age and trends by age at menopause were stronger for oestrogen receptor-positive disease than for oestrogen receptor-negative disease (p<0.01 for both comparisons). Interpretation The effects of menarche and menopause on breast cancer risk might not be acting merely by lengthening women's total number of reproductive years. Endogenous ovarian hormones are more relevant for oestrogen receptorpositive disease than for oestrogen receptor-negative disease and for lobular than for ductal tumours.
AB - Background Menarche and menopause mark the onset and cessation, respectively, of ovarian activity associated with reproduction, and affect breast cancer risk. Our aim was to assess the strengths of their effects and determine whether they depend on characteristics of the tumours or the affected women. Methods Individual data from 117 epidemiological studies, including 118 964 women with invasive breast cancer and 306 091 without the disease, none of whom had used menopausal hormone therapy, were included in the analyses. We calculated adjusted relative risks (RRs) associated with menarche and menopause for breast cancer overall, and by tumour histology and by oestrogen receptor expression. Findings Breast cancer risk increased by a factor of 1.050 (95% CI 1.044-1.057; p<0.0001) for every year younger at menarche, and independently by a smaller amount (1.029, 1.025-1.032; p<0.0001), for every year older at menopause. Premenopausal women had a greater risk of breast cancer than postmenopausal women of an identical age (RR at age 45-54 years 1.43, 1.33-1.52, p<0.001). All three of these associations were attenuated by increasing adiposity among postmenopausal women, but did not vary materially by women's year of birth, ethnic origin, childbearing history, smoking, alcohol consumption, or hormonal contraceptive use. All three associations were stronger for lobular than for ductal tumours (p<0.006 for each comparison). The effect of menopause in women of an identical age and trends by age at menopause were stronger for oestrogen receptor-positive disease than for oestrogen receptor-negative disease (p<0.01 for both comparisons). Interpretation The effects of menarche and menopause on breast cancer risk might not be acting merely by lengthening women's total number of reproductive years. Endogenous ovarian hormones are more relevant for oestrogen receptorpositive disease than for oestrogen receptor-negative disease and for lobular than for ductal tumours.
UR - http://www.scopus.com/inward/record.url?scp=84877875905&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877875905&partnerID=8YFLogxK
U2 - 10.1016/S1470-2045(12)70425-4
DO - 10.1016/S1470-2045(12)70425-4
M3 - Article
AN - SCOPUS:84877875905
VL - 13
SP - 1141
EP - 1151
JO - The Lancet Oncology
JF - The Lancet Oncology
SN - 1470-2045
IS - 11
ER -