Associations of age at menopause with health outcomes and mortality among females who are moderate and heavy smokers
Principal Investigator
Name
Shuguang Leng
Degrees
MBBS PhD
Institution
Regents of the University of New Mexico for its Public Operation Known as the Health Sciences Center
Position Title
Assistant Professor
Email
About this CDAS Project
Study
PLCO
(Learn more about this study)
Project ID
PLCO-981
Initial CDAS Request Approval
May 11, 2022
Title
Associations of age at menopause with health outcomes and mortality among females who are moderate and heavy smokers
Summary
Natural menopause is defined as the cessation of spontaneous menses for a period of 12 months, as a result of ovarian aging-induced estrogen depletion. Menopause can also be induced or facilitated by surgical treatments, e.g., bilateral ovariectomy or hysterectomy. Cigarette smoking is the leading preventable cause of mortality worldwide, and continues to be the major risk factor for lung cancer. Cigarette smoking also contributes to the premature ovarian aging. Female smokers have 2-fold increased risk for having early natural menopause (age at menopause <45). Our research team have identified early natural menopause as a risk factor for malignant and nonmalignant lung diseases and mortality among female smokers. However, majority of the associations reported in female smokers with natural menopause were not observed in female smokers with surgical menopause. Surgical menopause includes bilateral ovariectomy or hysterectomy without bilateral ovariectomy. A major difference between these two groups is that females with bilateral ovariectomy lose ovarian estrogen production while females with hysterectomy without bilateral ovariectomy continue to have ovarian estrogen secretion after operation. We hypothesize that associations between age at surgical menopause and cancer incidence and mortality could differ in female smokers with versus without bilateral oophorectomy. In addition, we will also explore the protective dietary factors that reduce the cancer incidence and mortality in female smokers with early loss of ovarian estrogen production. The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial prospective cohort is a well-characterized cohort with a substantial number of cancer incidences and deaths and a detailed collection of age at menopause and causes of menopause, which allows subgroup analysis in female smokers with bilateral oophorectomy or hysterectomy without bilateral ovariectomy. This study will help understand cancer risk and mortality in females smokers with early loss of ovarian estrogen production which is critical for cancer risk assessment and clinical intervention.
Aims
1) To assess the associations between age at menopause and cancer incidence and mortality in female smokers with natural menopause, bilateral ovariectomy, and hysterectomy without bilateral ovariectomy separately.
2) To identify the protective dietary factors that reduce the cancer incidence and mortality in female smokers with early loss of ovarian estrogen production.
3) To conduct Mendelian randomization analyses to address the causality of age at natural menopause for affecting outcomes of interest
Collaborators
Huining Kang, University of New Mexico
Xiaochun Gai, University of New Mexico
Yiliang Zhu, University of New Mexico