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Menopausal hormone therapy and risk of gastrointestinal cancer : Nested case-control study within a prospective cohort, and meta-analysis
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Green, Jane, Czanner, Gabriela, Reeves, Gillian, Watson, Joanna, Wise, Lesley, Roddam, Andrew and Beral, V. (Valerie) (2011) Menopausal hormone therapy and risk of gastrointestinal cancer : Nested case-control study within a prospective cohort, and meta-analysis. International Journal of Cancer, Vol.130 (No.10). pp. 2387-2396. doi:10.1002/ijc.26236 ISSN 0020-7136.
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Official URL: http://dx.doi.org/10.1002/ijc.26236
Abstract
Use of menopausal hormone therapy (HT) has been associated with reduced risk of colorectal cancer; evidence for its effect on other gastrointestinal cancers is limited. We conducted a nested case–control study within a UK cohort, and meta-analyses combining our results with those from published studies. Our study included women aged 50+ in the UK General Practice Research Database (GPRD): 1,054 with oesophageal, 750 with gastric and 4,708 with colorectal cancer, and 5 age- and practice-matched controls per case. Relative risks (RRs) and 95% confidence intervals (CIs) for cancer in relation to prospectively-recorded HT prescriptions were estimated by conditional logistic regression. Women prescribed HT had a reduced risk of oesophageal cancer (adjusted RR for 1+ vs. no HT prescriptions, 0.68, 95% CI 0.53–0.88; p = 0.004), gastric cancer (0.75, 0.54–1.05; p = 0.1) and colorectal cancer (0.81, 0.73–0.90; p < 0.001). There were no significant differences in cancer risk by HT type, estimated duration of HT use or between past and current users. In meta-analyses, risks for ever vs. never use of HT were significantly reduced for all three cancers (summary RR for oesophageal cancer, 0.68, 0.55–0.84, p < 0.001; for gastric cancer, 0.78, 0.65–0.94, p = 0.008; for colorectal cancer, 0.84, 0.81–0.88, p < 0.001). In high-income countries, estimated incidence over 5 years of these three cancers combined in women aged 50–64 was 2.9/1,000 in HT users and 3.6/1,000 in never users. The absolute reduction in risk of these cancers in HT users is small compared to the HT-associated increased risk of breast cancer.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Science > Statistics | ||||
Journal or Publication Title: | International Journal of Cancer | ||||
Publisher: | Wiley-Liss | ||||
ISSN: | 0020-7136 | ||||
Official Date: | 2011 | ||||
Dates: |
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Volume: | Vol.130 | ||||
Number: | No.10 | ||||
Page Range: | pp. 2387-2396 | ||||
DOI: | 10.1002/ijc.26236 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published |
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