Oral contraceptives, reproductive history and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition.
Tsilidis KK., Allen NE., Key TJ., Bakken K., Lund E., Berrino F., Fournier A., Olsen A., Tjønneland A., Overvad K., Boutron-Ruault MC., Clavel-Chapelon F., Byrnes G., Chajes V., Rinaldi S., Chang-Claude J., Kaaks R., Bergmann M., Boeing H., Koumantaki Y., Stasinopoulou G., Trichopoulou A., Palli D., Tagliabue G., Panico S., Tumino R., Vineis P., Bueno-de-Mesquita HB., van Duijnhoven FJ., van Gils CH., Peeters PH., Rodríguez L., González CA., Sánchez MJ., Chirlaque MD., Barricarte A., Dorronsoro M., Borgquist S., Manjer J., van Guelpen B., Hallmans G., Rodwell SA., Khaw KT., Norat T., Romaguera D., Riboli E.
BACKGROUND: Oral contraceptive use and reproductive factors may initiate long-term changes to the hormonal milieu and thereby, possibly influence colorectal cancer risk. METHODS: We examined the association of hormonal and reproductive factors with risk of colorectal cancer among 337,802 women in the European Prospective Investigation into Cancer and Nutrition, of whom 1878 developed colorectal cancer. RESULTS: After stratification for center and age, and adjustment for body mass index, smoking, diabetes mellitus, physical activity and alcohol consumption, ever use of oral contraceptives was marginally inversely associated with colorectal cancer risk (hazard ratio (HR), 0.92; 95% confidence interval (CI), 0.83-1.02), although this association was stronger among post-menopausal women (HR, 0.84; 95% CI: 0.74-0.95). Duration of oral contraceptive use and reproductive factors, including age at menarche, age at menopause, type of menopause, ever having an abortion, parity, age at first full-term pregnancy and breastfeeding, were not associated with colorectal cancer risk. CONCLUSION: Our findings provide limited support for a potential inverse association between oral contraceptives and colorectal cancer risk.