OBJECTIVES: We aimed to evaluate the relation between menstrual and reproductive factors, exogenous hormones, and risk of pancreatic cancer (PC). METHODS: Eleven case-control studies within the International Pancreatic Cancer Case-control Consortium took part in the present study, including in total 2838 case and 4748 control women. Pooled estimates of odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using a 2-step logistic regression model and adjusting for relevant covariates. RESULTS: An inverse OR was observed in women who reported having had hysterectomy (ORyesvs.no, 0.78; 95% CI, 0.67-0.91), remaining significant in postmenopausal women and never-smoking women, adjusted for potential PC confounders. A mutually adjusted model with the joint effect for hormone replacement therapy (HRT) and hysterectomy showed significant inverse associations with PC in women who reported having had hysterectomy with HRT use (OR, 0.64; 95% CI, 0.48-0.84). CONCLUSIONS: Our large pooled analysis suggests that women who have had a hysterectomy may have reduced risk of PC. However, we cannot rule out that the reduced risk could be due to factors or indications for having had a hysterectomy. Further investigation of risk according to HRT use and reason for hysterectomy may be necessary.

From the *Unit of Nutrition and Cancer Cancer Epidemiology Research Program Catalan Institute of Oncology Bilthoven; **Department of Gastroenterology and Hepatology University Medical Center Utrecht Utrecht The Netherlands; ††Department of Epidemiology and Biostatistics School of Public Health Imperial College London London UK; ‡‡Department of Social and Preventive Medicine Faculty of Medicine University of Malaya Kuala Lumpur Malaysia; §§Department of Cancer Epidemiology and Genetics Masaryk Memorial Cancer Institute Institute and MF MU Brno Czech Republic; ∥∥University Health Network Department of Surgery University of Toronto Toronto Canada; ¶¶Institute of Hygiene and Epidemiology 1st Faculty of Medicine Charles University Prague Prague; Department of Preventive Medicine Faculty of Medicine Palacky University Olomouc Czech Republic; ***National Cancer Institute Bethesda MD; †††Department of Medicine Memorial Sloan Kettering Cancer Center New York NY; ‡‡‡Department of Clinical Sciences and Community Health Università degli Studi di Milano Milan Italy; §§§Department of Hygiene Epidemiology and Medical Statistics School of Medicine University of Athens Greece; ∥∥∥Department of Epidemiology Harvard School of Public Health Boston MA; ¶¶¶M D Anderson Cancer Center University of Texas Houston TX; Dalla Lana School of Public Health University of Toronto Toronto Canada; ****Unit of Epidemiology and Biostatistics CRO Aviano National Cancer Institute IRCCS Aviano Italy; ††††Cancer Center and Institute of Oncology Warsaw Poland; and ‡‡‡‡Department of Chronic Disease Epidemiology Yale School of Public Health New Haven CT

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