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We pooled data from 11 studies from Europe, North America, and Japan. Analysis included 1572 <jats:styled-content style=\"fixed-case\">HNC<\/jats:styled-content> female cases and 4343 controls. Pooled odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s) estimates and their 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s) were calculated using multivariate logistic regression models adjusting for tobacco smoking and alcohol drinking. Lower risk was observed in women who used hormone replacement therapy (<jats:styled-content style=\"fixed-case\">HRT<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.58; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.34\u20130.77). Pregnancy (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.61; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.42\u20130.90) and giving birth (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.59; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.38\u20130.90) at &lt;35\u00a0years of age were inversely associated with <jats:styled-content style=\"fixed-case\">HNC<\/jats:styled-content>s. An inverse association with <jats:styled-content style=\"fixed-case\">HNC<\/jats:styled-content> was observed with age at start of <jats:styled-content style=\"fixed-case\">HRT<\/jats:styled-content> use (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.59; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.39\u20130.90) for each additional 10\u00a0years and with duration of use (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.87; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.76\u20130.99 for every 3\u00a0years). Exogenous female hormone use is associated with a nearly twofold risk reduction in female <jats:styled-content style=\"fixed-case\">HNC<\/jats:styled-content>s. The lower female <jats:styled-content style=\"fixed-case\">HNC<\/jats:styled-content> incidence may, in part, be explained by endogenous and exogenous estrogen exposures.<\/jats:p>","DOI":"10.1002\/cam4.1136","type":"journal-article","created":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T06:16:46Z","timestamp":1500013006000},"page":"1998-2007","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Hormone factors play a favorable role in female head and neck cancer risk"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0687-2910","authenticated-orcid":false,"given":"Dana","family":"Hashim","sequence":"first","affiliation":[{"name":"The Tisch Cancer Institute Icahn School of Medicine at Mount Sinai  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Sartori","sequence":"additional","affiliation":[{"name":"The Zena and Michael A. Weiner Cardiovascular Institute Icahn School of Medicine at Mount Sinai  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-897X","authenticated-orcid":false,"given":"Carlo La","family":"Vecchia","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences Universit\u00e0 degli Studi di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Serraino","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology and Biostatistics CRO Aviano National Cancer Institute IRCCS  Aviano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6163-200X","authenticated-orcid":false,"given":"Luigino Dal","family":"Maso","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology and Biostatistics CRO Aviano National Cancer Institute IRCCS  Aviano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Negri","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences Universit\u00e0 degli Studi di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Iowa College of Public Health  Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Levi","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine (IUMSP) Lausanne University Hospital (CHUV)  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Boccia","sequence":"additional","affiliation":[{"name":"The Tisch Cancer Institute Icahn School of Medicine at Mount Sinai  New York New York"},{"name":"Section of Hygiene Public Health Institute Catholic University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Cadoni","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Department Institute of Otorhinolaryngology Catholic University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung N.","family":"Luu","sequence":"additional","affiliation":[{"name":"Division of Epidemiology Vanderbilt Epidemiology Center Vanderbilt University School of Medicine  Nashville Tennessee"},{"name":"Department of Epidemiology and Biostatistics College of Public Health University of South Florida  Tampa Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan\u2010Chin Amy","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Family and Preventive Medicine and Huntsman Cancer Institute University of Utah School of Medicine  Salt Lake City Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Hashibe","sequence":"additional","affiliation":[{"name":"Department of Family and Preventive Medicine and Huntsman Cancer Institute University of Utah School of Medicine  Salt Lake City Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3811-2791","authenticated-orcid":false,"given":"Paolo","family":"Boffetta","sequence":"additional","affiliation":[{"name":"The Tisch Cancer Institute Icahn School of Medicine at Mount Sinai  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.50.3870"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-08-0347"},{"key":"e_1_2_6_4_1","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1054\/bjoc.1999.0900","article-title":"Risk factors for oral and pharyngeal cancer in women: a study from Italy and Switzerland","volume":"82","author":"Bosetti C.","year":"2000","journal-title":"Br. 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