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Menopausal hormone therapy and colorectal cancer: a linkage between nationwide registries in Norway.

ABSTRACT: OBJECTIVES:With the present study, we aimed to investigate the association between menopausal hormone therapy (HT) and risk of colorectal cancer (CRC). SETTING:Cohort study based on the linkage of Norwegian population-based registries. PARTICIPANTS:We selected 466822 Norwegian women, aged 55-79, alive and residing in Norway as of 1 January 2004, and we followed them from 2004 to 2008. Each woman contributed person-years at risk as non-user, current user and/or past HT user. OUTCOME MEASURES:The outcome of interest was adenocarcinoma of the colorectal tract, overall, by anatomic site and stage at diagnosis. Incidence rate ratios (RRs) with 95%?CIs were estimated by Poisson regression and were used to evaluate the association between HT and CRC incidence. RESULTS:During the median follow-up of 4.8 years, 138?655 (30%) women received HT and 3799 (0.8%) incident CRCs occurred. Current, but not past, use of HT was associated with a lower risk of CRC (RR 0.88; 95% CI 0.80 to 0.98). RRs for localised, regionally advanced and metastatic CRC were 1.13 (95% CI 0.91 to 1.41), 0.81 (95% CI 0.70 to 0.94) and 0.79 (95% CI 0.62 to 1.00), respectively. RRs for current use of oestrogen therapy (ET) were 0.91 (95%?CI 0.80 to 1.04) while RR for current use of combined oestrogen-progestin therapy (EPT) was 0.85 (95% CI 0.70 to 1.03), as compared with no use of HT. The same figures for ET and EPT in oral formulations were 0.83 (95% CI 0.68 to 1.03) and 0.86 (95% CI 0.71 to 1.05), respectively. CONCLUSIONS:In our nationwide cohort study, HT use lowered the risk of CRC, specifically the most advanced CRC.

SUBMITTER: Botteri E

PROVIDER: S-EPMC5695317 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Menopausal hormone therapy and colorectal cancer: a linkage between nationwide registries in Norway.

Botteri Edoardo E Støer Nathalie C NC Sakshaug Solveig S Graff-Iversen Sidsel S Vangen Siri S Hofvind Solveig S de Lange Thomas T Bagnardi Vincenzo V Ursin Giske G Weiderpass Elisabete E

BMJ open 20171115 11

<h4>Objectives</h4>With the present study, we aimed to investigate the association between menopausal hormone therapy (HT) and risk of colorectal cancer (CRC).<h4>Setting</h4>Cohort study based on the linkage of Norwegian population-based registries.<h4>Participants</h4>We selected 466822 Norwegian women, aged 55-79, alive and residing in Norway as of 1 January 2004, and we followed them from 2004 to 2008. Each woman contributed person-years at risk as non-user, current user and/or past HT user. ...[more]

PMID: 29146641

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Project description:BackgroundMenopausal hormone therapy (MHT) is a risk factor for breast cancer (BC). Evidence suggests that its effect on BC risk could be partly mediated by mammographic density. The aim of this study was to investigate the relationship between MHT, mammographic density and BC risk using data from a prospective study.MethodsWe used data from a case-control study nested within the French cohort E3N including 453 cases and 453 matched controls. Measures of mammographic density, history of MHT use during follow-up and information on potential confounders were available for all women. The association between MHT and mammographic density was evaluated by linear regression models. We applied mediation modelling techniques to estimate, under the hypothesis of a causal model, the proportion of the effect of MHT on BC risk mediated by percent mammographic density (PMD) for BC overall and by hormone receptor status.ResultsAmong MHT users, 4.2% used exclusively oestrogen alone compared with 68.3% who used exclusively oestrogens plus progestogens. Mammographic density was higher in current users (for a 60-year-old woman, mean PMD 33%; 95% CI 31 to 35%) than in past (29%; 27 to 31%) and never users (24%; 22 to 26%). No statistically significant association was observed between duration of MHT and mammographic density. In past MHT users, mammographic density was negatively associated with time since last use; values similar to those of never users were observed in women who had stopped MHT at least 8 years earlier. The odds ratio of BC for current versus never MHT users, adjusted for age, year of birth, menopausal status at baseline and BMI, was 1.67 (95% CI, 1.04 to 2.68). The proportion of effect mediated by PMD was 34% for any BC and became 48% when the correlation between BMI and PMD was accounted for. These effects were limited to hormone receptor-positive BC.ConclusionsOur results suggest that, under a causal model, nearly half of the effect of MHT on hormone receptor-positive BC risk is mediated by mammographic density, which appears to be modified by MHT for up to 8 years after MHT termination.

Dataset Information

Menopausal hormone therapy and colorectal cancer: a linkage between nationwide registries in Norway.

Publications

Menopausal hormone therapy and colorectal cancer: a linkage between nationwide registries in Norway.

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