Cancer Causes & Control

, Volume 18, Issue 7, pp 723–733 | Cite as

Exogenous hormones and colorectal cancer risk in Canada: associations stratified by clinically defined familial risk of cancer

  • Peter T. Campbell
  • Polly Newcomb
  • Steven Gallinger
  • Michelle Cotterchio
  • John R. McLaughlin
Original Paper

Abstract

Objective

This work assessed associations between colorectal cancer risk and postmenopausal/contraceptive hormones; subgroup analyses included women with a clinically defined family history of cancer.

Methods

A population based case–control study of incident colorectal cancer was conducted among women aged 20–74 years in Ontario and Newfoundland & Labrador, Canada. Incident cases (n = 1,404) were selected from provincial cancer registries and controls (n = 1,203) were identified through property records, and other means, between January 1997 and April 2006. Family history of cancer, exogenous hormone-use, and other risk factors were collected via self-administered questionnaires. Multivariate unconditional logistic regression analyses were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs).

Results

Decreased risks of colorectal cancer were observed with ever-users of: hormonal contraceptives (OR: 0.77; CI: 0.65–0.91), estrogen-only postmenopausal hormones (OR: 0.60; CI: 0.47–0.75), and estrogen–progestin postmenopausal hormones (OR: 0.70; CI: 0.52–0.95). Risk estimates were similar between women with and without a strong familial history of cancer. Age at initiation of hormonal contraceptives was associated with colorectal cancer risk; women who initiated use at younger ages (age <22 years: OR: 0.60; CI: 0.47–0.77) experienced a greater reduced risk of disease than women who initiated use at later ages (age 30+: OR: 0.92; CI: 0.68–1.24; ptrend: 0.0026).

Conclusions

These results indicate that exogenous hormone-use is linked with reduced risk of colorectal cancer among women with a strong familial risk of cancer, consistent with observations on population samples of sporadic colorectal cancer cases. A potential age-effect for use of hormonal contraceptives warrants further attention.

Keywords

Postmenopausal hormones HRT Contraceptives Colorectal cancer Family history of cancer Amsterdam criteria Bethesda criteria 

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Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Peter T. Campbell
    • 1
    • 2
  • Polly Newcomb
    • 2
  • Steven Gallinger
    • 3
  • Michelle Cotterchio
    • 4
    • 5
  • John R. McLaughlin
    • 1
    • 4
    • 5
  1. 1.Prosserman Centre for Health ResearchSamuel Lunenfeld Research Institute, Mount Sinai HospitalTorontoCanada
  2. 2.Cancer Prevention ProgramFred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.Department of SurgeryMount Sinai HospitalTorontoCanada
  4. 4.Division of Preventive OncologyCancer Care OntarioTorontoCanada
  5. 5.Department of Public Health SciencesUniversity of TorontoTorontoCanada

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