Hormone replacement therapy and improved survival among postmenopausal women diagnosed with colon cancer (USA)
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Objectives: Hormone replacement therapy (HRT) has been inversely associated with colon cancer incidence in several epidemiologic studies. In this study we used data from a population-based incident case–control study of colon cancer to evaluate the role of HRT use in survival after diagnosis with colon cancer.
Methods: Data from 815 postmenopausal women living in Utah, California, and Minnesota diagnosed between 1 September 1991 and 30 September 1994 were used to examine associations between HRT and survival.
Results: After adjusting for age at time of diagnosis, stage of disease at time of diagnosis, study center, and body mass index (BMI), we observed that women who had ever used HRT had a 30% lesser probability of dying of any cause and a 40% lower probability of dying from colon cancer specifically during the follow-up period. Further evaluation by years of HRT use showed that those who had used HRT for 4 or more years had the lowest risk of dying of colon cancer (hazard rate ratio 0.5, 95% confidence interval 0.3–0.9). Evaluation of other lifestyle variables with HRT use did not show significant confounding or effect modification.
Conclusions: These findings suggest that HRT use may improve short-term survival after diagnosis with colon cancer; there is no suggestion that HRT use is detrimental to survival.
- Wingo PA, Ries LA, Rosenberg HM, Miller DS, Edwards BK (1998) Cancer incidence and mortality, 1973–1995. Cancer 82: 1197-1207.
- Potter JD, Slattery ML, Bostick RM, Gasptur SM (1993) Colon cancer: a review of the epidemiology. Epidemiol Rev 15: 499-545.
- Slattery ML, French TK, Egger MJ, Lyon JL (1989) Diet and survival of patients with colon cancer in Utah: is there an association? Int I Epidemiol 18: 792-797.
- Selby JV, Friedman GD, Quesenberry CP, Weiss NS (1992) A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 326: 653-657.
- Jacobs EJ, White E, Weiss NS (1994) Exogenous hormones, reproductive history, and colon cancer (Seattle, Washington, USA). Cancer Causes Control 5: 359-366.
- Newcomb PA, Storer BE (1995) Postmenopausal hormone use and risk of large-bowel cancer. J Natl Cancer Inst 87: 1067-1071.
- Hebert-Croteau N (1998) A meta-analysis of hormone replacement therapy and colon cancer in women. Cancer Epidemiol Biomarkers Prev 7: 653-660.
- Potter JD, Bostick RM, Grandits GA, Fosdick L, Elmer P, Wood J, Grambsch P, Louis TA (1996) Hormone replacement therapy is associated with lower risk of adenomatous polyps of the large bowel: the Minnesota Cancer Prevention Research Unit Case-Control Study. Cancer Epidemiol Biomarkers Prev 10: 779-784.
- Everson GT, McKinley C, Kern F (1991) Mechanisms of gallstone formation in women. Effects of exogenous estrogen and dietary cholesterol on hepatic lipid metabolism. J Clin Invest 87: 237-246.
- Lointier P, Wildrick DM, Boman BM (1992) The effects of steroid hormones on a human colon cancer cell line in vitro. Anticancer Res 12: 1327-1330.
- Issa JPJ, Ottaviano YL, Celano P, et al. (1994) Methylation of the estrogen receptor CpG island links aging and neoplasia in human colon. Nature Genet 7: 536-540.
- Potter JD (1995) Hormones and colon cancer. J Natl Cancer Inst 87: 1039-1040.
- Kampman E, Potter JD, Slattery ML, Caan BJ, Edwards S (1997) Hormone replacement therapy, reproductive history, and colon cancer: a multicenter, case-control study in the United States. Cancer Causes Control 8: 146-158.
- Edwards SL, Slattery ML, Mori M, et al. (1994) Objective system for interviewer performance evaluation for use in epidemiologic studies. Am J Epidemiol 140: 1020-1028.
- Slattery ML, Caan BJ, Duncan D, Berry TD, Coates A, Kerber R (1994) A computerized diet history questionnaire for epidemiologic studies. J Am Diet Assoc 94: 761-766.
- Criqui MH, Suarez L, Barrett-Connor E, McPhillips J, Wingard DL, Garland C (1988) Postmenopausal estrogen use and mortality. Results from a prospective study in a defined, homogeneous community. Am J Epidemiol 128: 606-614.
- Ettinger B, Friedman GD, Bush T, Quesenberry CP Jr (1996) Reduced morality associated with long-term postmenopausal estrogen therapy. Obstet Gynecol 87: 6-12.
- Henderson BE, Paganini-Hill A, Ross RK (1991) Decreased mortality in users of estrogen replacement therapy. Arch Intern Med 151: 75-78.
- Grodstein F, Stampher MJ, Colditz GA et al. (1997) Postmenopausal hormone therapy and mortality. N Engl J Med 336: 1769-1775.
- Singh S, Paraskeva C, Gallimore PH, et al. (1994) Differential growth response to oestrogen of premalignant and malignant colonic cell lines. Anticancer Res 14: 1037-1042.
- Maminta MLD, Molteni A, Rosen ST (1991) Stable expression of the human estrogen receptor in HeLa cells by infection: effect of estrogen on cell proliferation and c-myc expression. Mol Cell Endocrinol 78: 61-69.
- Tutton PJM, Barkla DH (1982) Differential effects of estrogenic hormones on cell proliferation in the epithelium and colonic carcinomata of rats. Anticancer Res 2: 199-202.
- Holli K, Isola J, Cuzick J (1998) Low biologic aggressiveness in breast cancer in women using hormone replacement therapy. J Clin Oncol 16: 3115-3120.
- Hormone replacement therapy and improved survival among postmenopausal women diagnosed with colon cancer (USA)
Cancer Causes & Control
Volume 10, Issue 5 , pp 467-473
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers
- Additional Links
- colon cancer
- disease stage
- hormone replacement therapy
- Industry Sectors
- Author Affiliations
- 1. School of Medicine, University of Utah, Salt Lake City, Utah, 84108, USA
- 2. School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- 3. Kaiser Permanente Medical Care Program, Oakland, California, USA
- 4. Fred Hutchinson Cancer Center, Seattle, Washington, DC, USA