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Colorectal cancer incidence and postmenopausal hormone use by type, recency, and duration in cancer prevention study II.
Cancer Epidemiol Biomarkers Prev. 2009 Nov; 18(11):2835-41.CE

Abstract

The Women's Health Initiative randomized trials showed a reduction in colorectal cancer risk with the use of estrogen plus progesterone (E + P), but not with estrogen alone (E-only), after intervention periods <7 years. Using data from the Cancer Prevention Study II Nutrition Cohort, we examined associations of colorectal cancer risk with E-only and E + P, including analyses by recency and duration of hormone use. During 13.2 years of follow-up, 776 cases of invasive colorectal cancer occurred among 67,412 postmenopausal women participants. Cox proportional hazards models were used to estimate multivariate-adjusted relative risks (RR) and 95% confidence intervals (95% CI) of colorectal cancer for current and former hormone users according to hormone type and duration of use. Relative to women who never used postmenopausal hormones, current, but not former, use of E-only was associated with a reduced risk of colorectal cancer (RR 0.76; 95% CI, 0.59-0.97). Among current E-only users, duration of use was inversely and linearly associated with risk (P(trend) = 0.01). Use of E-only for <5 years was not associated with reduced risk, whereas use for >or=20 years was associated with a 45% reduction in risk (RR, 0.55; 95% CI, 0.36-0.86). There were no statistically significant associations between E + P and colorectal cancer risk. Our results suggest a strong inverse association of long-term use of E-only with colorectal cancer risk, underscoring the importance of collecting data on duration of hormone use in epidemiologic studies of postmenopausal hormones and risk of disease.

Authors+Show Affiliations

Department of Epidemiology, American Cancer Society, Atlanta, Georgia 30303, USA. janet.hildebrand@cancer.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19843681

Citation

Hildebrand, Janet S., et al. "Colorectal Cancer Incidence and Postmenopausal Hormone Use By Type, Recency, and Duration in Cancer Prevention Study II." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 18, no. 11, 2009, pp. 2835-41.
Hildebrand JS, Jacobs EJ, Campbell PT, et al. Colorectal cancer incidence and postmenopausal hormone use by type, recency, and duration in cancer prevention study II. Cancer Epidemiol Biomarkers Prev. 2009;18(11):2835-41.
Hildebrand, J. S., Jacobs, E. J., Campbell, P. T., McCullough, M. L., Teras, L. R., Thun, M. J., & Gapstur, S. M. (2009). Colorectal cancer incidence and postmenopausal hormone use by type, recency, and duration in cancer prevention study II. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 18(11), 2835-41. https://doi.org/10.1158/1055-9965.EPI-09-0596
Hildebrand JS, et al. Colorectal Cancer Incidence and Postmenopausal Hormone Use By Type, Recency, and Duration in Cancer Prevention Study II. Cancer Epidemiol Biomarkers Prev. 2009;18(11):2835-41. PubMed PMID: 19843681.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colorectal cancer incidence and postmenopausal hormone use by type, recency, and duration in cancer prevention study II. AU - Hildebrand,Janet S, AU - Jacobs,Eric J, AU - Campbell,Peter T, AU - McCullough,Marjorie L, AU - Teras,Lauren R, AU - Thun,Michael J, AU - Gapstur,Susan M, Y1 - 2009/10/20/ PY - 2009/10/22/entrez PY - 2009/10/22/pubmed PY - 2010/1/28/medline SP - 2835 EP - 41 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 18 IS - 11 N2 - The Women's Health Initiative randomized trials showed a reduction in colorectal cancer risk with the use of estrogen plus progesterone (E + P), but not with estrogen alone (E-only), after intervention periods <7 years. Using data from the Cancer Prevention Study II Nutrition Cohort, we examined associations of colorectal cancer risk with E-only and E + P, including analyses by recency and duration of hormone use. During 13.2 years of follow-up, 776 cases of invasive colorectal cancer occurred among 67,412 postmenopausal women participants. Cox proportional hazards models were used to estimate multivariate-adjusted relative risks (RR) and 95% confidence intervals (95% CI) of colorectal cancer for current and former hormone users according to hormone type and duration of use. Relative to women who never used postmenopausal hormones, current, but not former, use of E-only was associated with a reduced risk of colorectal cancer (RR 0.76; 95% CI, 0.59-0.97). Among current E-only users, duration of use was inversely and linearly associated with risk (P(trend) = 0.01). Use of E-only for <5 years was not associated with reduced risk, whereas use for >or=20 years was associated with a 45% reduction in risk (RR, 0.55; 95% CI, 0.36-0.86). There were no statistically significant associations between E + P and colorectal cancer risk. Our results suggest a strong inverse association of long-term use of E-only with colorectal cancer risk, underscoring the importance of collecting data on duration of hormone use in epidemiologic studies of postmenopausal hormones and risk of disease. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/19843681/Colorectal_cancer_incidence_and_postmenopausal_hormone_use_by_type_recency_and_duration_in_cancer_prevention_study_II_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=19843681 DB - PRIME DP - Unbound Medicine ER -