Highlights
- •Early menopause (≤45 years) is associated with an increased risk of lung cancer, although this risk is primarily among smokers.
- •Case-control studies have found that late menopause (≥55 years) is also associated with an increased risk of lung cancer, but mainly among non-smokers.
- •Large prospective cohort studies are needed to confirm the association between late menopause and lung cancer risk among non-smokers.
- •Further research is required to investigate the underlying molecular mechanisms, especially the interaction between tobacco carcinogens and sex hormones in lung cancer development.
Abstract
Previous reviews have found that menstrual and reproductive factors are associated
with lung cancer risk, but evidence on a possible association with age at menopause
is inconsistent. This review aimed to determine the association of early and late
menopause with lung cancer risk. Publications were reviewed and obtained through PubMed,
EMBASE and Scopus database search up to March 2021. The pooled relative risks (RRs)
or odds ratios (ORs) and corresponding 95% CIs were estimated using a random-effects
meta-analysis. Twenty-eight studies were included in at least one meta-analysis, of
age at menopause (lowest vs highest; n=26), early menopause (≤45 vs ≥50/51 years or
middle; n=11), late menopause (≥55 vs <50 years or middle; n=6), or continuous (per
additional year; n=6). We found that early menopause was associated with lung cancer
in both cohort studies (RR 1.26, 1.10-1.41; n=6) and case-control studies (OR 1.38,
1.11-1.66; n=5). Three large cohort studies showed that the increased risk was primarily
evident among smokers (RR 1.38, 1.10-1.66) but not among non-smokers (RR 1.02, 0.63-1.40).
Four case-control studies found that late menopause was also associated with lung
cancer (OR 1.29, 1.08-1.51); conversely, the association was mainly observed among
non-smokers (OR 1.35, 1.11-1.59) but not among smokers (OR 1.05, 0.75-1.36). In conclusion,
evidence from this review indicates an increased risk of lung cancer in women who
experience early menopause (≤45 years), although this risk is primarily among smokers.
Large prospective cohort studies are needed to confirm the association between late
menopause (≥55 years) and lung cancer risk among non-smokers. PROSPERO registration:
CRD42020205429
Keywords
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Article info
Publication history
Published online: July 20, 2021
Accepted:
July 16,
2021
Received in revised form:
July 6,
2021
Received:
May 11,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
