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The role of pregnancy, perinatal factors and hormones in maternal cancer risk: a review of the evidence
NCI, Div Canc Epidemiol & Biostat, NIH, Rockville, MD USA.
Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway;Canc Registry Norway, Oslo, Norway.
Natl Inst Hlth & Welf THL, Informat Serv Dept, Helsinki, Finland;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, Stockholm, Sweden.
Canc Registry Norway, Oslo, Norway.
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2018 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 283, no 5, p. 430-445Article in journal (Refereed) Published
Abstract [en]

An understanding of the origin of cancer is critical for cancer prevention and treatment. Complex biological mechanisms promote carcinogenesis, and there is increasing evidence that pregnancy related exposures influence foetal growth cell division and organ functioning and may have a longlasting impact on health and disease susceptibility in the mothers and offspring. Nulliparity is an established risk factor for breast, ovarian, endometrial and possibly pancreatic cancer, whilst the risk of kidney cancer is elevated in parous compared with nulliparous women. For breast, endometrial and ovarian cancer, each pregnancy provides an additional risk reduction. The associations of parity with thyroid and colorectal cancers are uncertain. The timing of reproductive events is also recognized to be important. Older age at first birth is associated with an increased risk of breast cancer, and older age at last birth is associated with a reduced risk of endometrial cancer. The risks of breast and endometrial cancers increase with younger age at menarche and older age at menopause. The mechanisms, and hormone profiles, that underlie alterations in maternal cancer risk are not fully understood and may differ by malignancy. Linking health registries and pooling of data in the Nordic countries have provided opportunities to conduct epidemiologic research of pregnancy exposures and subsequent cancer. We review the maternal risk of several malignancies, including those with a well-known hormonal aetiology and those with less established relationships. The tendency for women to have fewer pregnancies and at later ages, together with the age-dependent increase in the incidence of most malignancies, is expected to affect the incidence of pregnancy-associated cancer.

Place, publisher, year, edition, pages
2018. Vol. 283, no 5, p. 430-445
Keywords [en]
breast cancer, colorectal cancer, endometrial cancer, Nordic registries, ovarian cancer, Pregnancy
National Category
Cancer and Oncology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-355465DOI: 10.1111/joim.12747ISI: 000430468100002PubMedID: 29476569OAI: oai:DiVA.org:uu-355465DiVA, id: diva2:1229290
Available from: 2018-06-29 Created: 2018-06-29 Last updated: 2018-06-29Bibliographically approved

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Sköld, CamillaGlimelius, Ingrid

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