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Hormone replacement therapy, reproductive history, and colon cancer: a multicenter, case-control study in the United States

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Abstract

Hormonal factors have been inconsistently associated with coloncancer risk in women. The associations between reproductive events, menstrualfactors, exogenous hormones, and colon cancer were evaluated in a largecase-control study (894 female cases and 1,120 female age-matchedpopulation-based controls) in the United States, stratifying by age atdiagnosis, tumor site, family history and other potential risk factors.Overall, higher parity was associated with a marginally decreased risk ofcolon cancer (five or more births compared with nulliparous: odds ratio [OR]= 0.75, 95 percent confidence interval [CI] = 0.53-1.06) after adjusting forage at diagnosis, family history of colorectal cancer, vigorous lifetimephysical activity, body mass index (BMI) (wt/ht 1.5 ), total energy intake,and aspirin use. No important associations were observed for otherreproductive or menstrual events. An inverse association between recent useof hormone replacement therapy (HRT) and colon cancer was observed (OR = 0.71, CI = 0.56-0.89). Although interaction termswere not significant, this inverse association appeared to be more pronouncedfor those with an older age at diagnosis; for those without a first-degreerelative with colorectal cancer; and for those with a relatively low BMI. Thereduced risk associated with HRT use did not appear to be explained by otherbehaviors related to HRT use.

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References

  1. Fraumeni JF Jr, Lloyd JW, Smith EM, Wagoner JK. Cancer mortality among nuns: role of marital status in etiology of neoplastic disease in women. JNCI 1969; 42: 455–67.

    Google Scholar 

  2. McMichael AJ, Potter JD. Reproduction, endogenous and exogenous sex hormones, and colon cancer: A review and hypothesis. JNCI 1980; 65: 1201–7.

    Google Scholar 

  3. Potter JD, Slattery ML, Bostick RM, Gapstur SM. Colon cancer: a review of the epidemiology. Epidemiol Rev 1993; 15: 499–545.

    Google Scholar 

  4. Potter JD. Hormones and colon cancer [Editorial]. JNCI 1995; 87: 1039–40.

    Google Scholar 

  5. Wu-Williams AH, Lee M, Whittemore AS, et al. Reproductive factors and colorectal cancer risk among Chinese females. Cancer Res 1991; 51: 2307–11.

    Google Scholar 

  6. Davis FG, Furner SE, Persky V, Koch M. The influence of parity and exogenous female hormones on the risk of colorectal cancer. Int J Cancer 1989; 43: 587–90.

    Google Scholar 

  7. Slattery ML, Potter JD, Sorenson AW. Age and risk factors for colon cancer (United States and Australia): Are there implications for understanding differences in case-control and cohort studies? Cancer Causes Control 1994; 5: 557–63.

    Google Scholar 

  8. Kvåle G, Heuch I. Is the incidence of colorectal cancer related to reproduction? A prospective study of 63,000 women. Int J Cancer 1991; 47: 390–5.

    Google Scholar 

  9. Broeders MJM, Lambe M, Baron JA, Leon DA. History of childbearing and colorectal cancer risk in women aged less than 60: an analysis of Swedish routine registry data 1960-1984. Int J Cancer 1996; 66: 170–5.

    Google Scholar 

  10. Slattery ML, Mineau GP, Kerber RA. Reproductive factors and colon cancer: the influences of age, tumor site, and family history on risk (Utah, United States). Cancer Causes Control 1995; 6: 332–8.

    Google Scholar 

  11. Furner SE, Davis GD, Nelson RL, Haenszel W. A casecontrol study of large bowel cancer and hormone exposure in women. Cancer Res 1989; 49: 4936–40.

    Google Scholar 

  12. Gerhardsson de Verdier M, London S. Reproductive factors, exogenous female hormones, and colorectal cancer by subsite. Cancer Causes Control 1992; 3: 355–60

    Google Scholar 

  13. Jacobs EJ, White E, Weiss NS. Exogenous hormones, reproductive history, and colon cancer (Seattle, Washington, USA). Cancer Causes Control 1995; 5: 359–66.

    Google Scholar 

  14. Calle EE, Miracle-McMahill HL, Thun MJ, Heath CW. Estrogen replacement therapy and risk of fatal colon cancer in a prospective cohort of postmenopausal women. JNCI 1995; 87: 517–23.

    Google Scholar 

  15. Chute CG, Willett WC, Colditz GA, Stampfer MJ, Rosner B, Speizer FE. A prospective study of reproductive history and exogenous estrogens on the risk of colorectal cancer in women. Epidemiology 1991; 2: 201–7.

    Google Scholar 

  16. Marcus PM, Newcomb PA, Young T, Storer BE. The association of reproductive and menstrual characteristics and colon and rectal cancer risk in Wisconsin women. Ann Epidemiol 1995; 5: 303–9.

    Google Scholar 

  17. Newcomb PA, Storer BE. Postmenopausal hormone use and risk of large bowel cancer. JNCI 1995; 87: 1067–71.

    Google Scholar 

  18. Folsom AR, Mink PJ, Sellers TA, Hong CP, Zheng W, Potter JD. Hormone replacement therapy and morbidity and mortality in a prospective study of postmenopausal women. Am J Public Health 1995; 85: 1128–32.

    Google Scholar 

  19. Fernandez E, La Vecchia C, A'Avanzo B, Franceschi S, Negri E, Parazzini F. Oral contraceptives, hormone replacement therapy and the risk of colorectal cancer. Br J Cancer 1996; 73: 1431–6.

    Google Scholar 

  20. Grodstein F, Martinez ME, Giovannucci EL, et al. Postmenopausal hormone use and colorectal cancer in the Nurses' Health Study. Am J Epidemiol 1996; 143: S63.

    Google Scholar 

  21. Weiss NS, Daling JR, Chow WH. Incidence of cancer of the large bowel in relation to reproductive and hormonal factors. JNCI 1981; 67: 57–60.

    Google Scholar 

  22. Wu AH, Paganini-Hill RA, Ross RK, et al. Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study. Br J Cancer 1987; 55: 687–94.

    Google Scholar 

  23. Wu-Williams AH, Lee M, Whittemore AS, et al. Reproductive factors and colorectal cancer risk among Chinese females. Cancer Res 1991; 51: 2307–11.

    Google Scholar 

  24. Risch HA, Howe GR. Menopausal hormone use and colorectal cancer in Saskatchewan: a record linkage cohort study. Cancer Epidemiol Biomark Prev 1995; 4: 21–8.

    Google Scholar 

  25. Peters RK, Pike MC, Chang WWL, Mack MT. Reproductive factors and colon cancer. Br J Cancer 1990; 61: 741–8.

    Google Scholar 

  26. Troisi R, Schairer C, Chow W-H, Schatzkin A, Brinton LA, Fraumeni JF Jr. A prospective study of menopausal hormones and risk of colorectal cancer (United States). Cancer Causes Control 1997; 8: 130–8.

    Google Scholar 

  27. Potter JD, McMichael AJ. Large bowel cancer in women in relation to reproductive and hormonal factors: a casecontrol study. JNCI 1983; 71: 703–9.

    Google Scholar 

  28. Derby CA, Hume AL, Barbour MM, McPhillips JB, Lasater TM, Carleton RA. Correlates of post-menopausal estrogen use and trends through the 1980s in two southeastern New England communities. Am J Epidemiol 1993; 137: 1125–35.

    Google Scholar 

  29. Percy C, Van Holten V, Muir C, eds. International Classification of Diseases for Oncology, Second Edition. Geneva, Switzerland: World Health Organization, 1990.

    Google Scholar 

  30. Slattery ML, Potter J, Caan B, et al. Energy balance and colon cancer-beyond physical activity. Cancer Res 1997; 57: 75–80.

    Google Scholar 

  31. Slattery ML, Edwards SL, Caan BJ, Kerber RA, Potter JD. Response rates among control subjects in case-control studies. Ann Epidemiol 1995; 5: 245–9.

    Google Scholar 

  32. Edwards S, Slattery ML, Mori M, et al. Objective system for interviewer performance evaluation for use in epidemiologic studies. Am J Epidemiol 1994; 140: 1020–8.

    Google Scholar 

  33. Micozzi MS, Albanes D, Jones Y, Chumlea WC. Correlations of body mass indices with weight, stature, and body composition in men and women in NHANES I and II. Am J Clin Nutr 1986; 44: 725–31.

    Google Scholar 

  34. McDonald A, Van Horn L, Slattery ML, et al, The CARDIA dietary history, development and implementation. J Am Diet Assn 1991; 91: 1104–200.

    Google Scholar 

  35. Liu K, Slattery ML, Jacobs DR, et al. The reliability and relative validity of the CARDIA diet history. J Ethnic Dis 1994; 4: 15–27.

    Google Scholar 

  36. Sidney S, Jacobs DR, Haskell W, et al. Comparison of two methods of assessing physical activity in the CARDIA study. Am J Epidemiol 1991; 133:1231–45.

    Google Scholar 

  37. SAS Institute Inc. SAS/STAT User's Guide Version 6, Fourth Edition, Volume 2. Cary, NC (USA): SAS Institute Inc., 1990.

    Google Scholar 

  38. Breslow NE, Day NE. Statistical Methods in Cancer Research. Vol I. The Analysis of Case Control Studies. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32.

    Google Scholar 

  39. Harlow SD, Linet MS. Agreement between questionnaire data and medical records. The evidence for accuracy of recall. Am J Epidemiol 1989; 129: 233–48.

    Google Scholar 

  40. Goodman MT, Nomura AM, Wilkens LR, et al. Agreement between interview information and physician records on history of menopausal estrogen use. Am J Epidemiol 1990; 131: 815–25.

    Google Scholar 

  41. Kampman E, Giovannucci E, Van 't Veer P, et al Calcium, vitamin D, dairy foods, and the occurrence of colorectal adenomas among men and women in two prospective studies. Am J Epidemiol 1994; 191: 16–29.

    Google Scholar 

  42. Giovannucci E, Egan KM, Hunter DJ, et al. Aspirin and the risk of colorectal cancer in women. New Engl J Med 1995; 333: 609–14.

    Google Scholar 

  43. Potter JD, Bostick RM, Grandits GA, et al. Hormone replacement therapy is associated with lower risk of adenomatous polyps of the large bowel: the Minnesota CPRU Case-Control Study. Cancer Epidemiol Biomark Prev 1996; 5: 779–84.

    Google Scholar 

  44. McKeown-Eyssen G. Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk? Cancer Epidemiol Biomark Prev 1994; 3: 687–95.

    Google Scholar 

  45. McMichael AJ, Potter JD. Host factors in carcinogenesis: certain bile-acid metabolic profiles that selectively increase the risk of proximal colon cancer. JNCI 1985; 75: 185–91.

    Google Scholar 

  46. Issa JPJ, Ottaviano YL, Celano P, Hamilton SR, Davidson NE, Baylin SB. Methylation of the oestrogen receptor CpG island links aging and neoplasia in human colon. NatGenet 1994; 7: 536–40.

    Google Scholar 

  47. Wysowski DK, Golden L, Burke L. Use of menopausal estrogens and medroxyprogesterone in the United States, 1982-1992. Obstet Gynecol 1995; 85: 6–10.

    Google Scholar 

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Authors and Affiliations

  1. Fred Hutchinson Cancer Research Center, Cancer Prevention Research Program, Seattle, USA

    Ellen Kampman & John D. Potter

  2. University of Utah, Salt Lake City, USA

    Martha L. Slattery & Sandra Edwards

  3. Kaiser Permanente Medical Research Program, Oakland, USA

    Bette J. Caan

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  1. Ellen Kampman
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  2. John D. Potter
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  3. Martha L. Slattery
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  4. Bette J. Caan
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  5. Sandra Edwards
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Kampman, E., Potter, J.D., Slattery, M.L. et al. Hormone replacement therapy, reproductive history, and colon cancer: a multicenter, case-control study in the United States. Cancer Causes Control 8, 146–158 (1997). https://doi.org/10.1023/A:1018459911147

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