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Estrogen replacement therapy and colorectal cancer risk in elderly women

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Colorectal cancer is the fourth most common incident cancer in the United States and causes more cancer deaths than any site except lung. Twenty-two epidemiologic studies have examined the relationship of estrogen replacement therapy and colon and rectal cancers with inconsistent results. However, recent studies suggest a reduced risk among current users. The purpose of the present study was to analyze the Leisure World Cohort for possible association of estrogen replacement therapy with colorectal cancer risk. METHODS: A cohort of 7,701 female members who were initially free of cancer and self-reported their use of estrogen replacement therapy were followed up from June 1981 through December 1995 for development of colorectal cancer. RESULTS: We observed 249 incident colorectal cancer cases and 89 colorectal cancer deaths. Women who had used estrogen replacement therapy had an age-adjusted colorectal cancer incidence rate of 2.67 per 1,000 person-years compared with 3.30 per 1,000 personyears among lifetime nonusers (relative risk =0.81; 95 percent confidence interval, 0.63 to 1.04). Among recent users the incidence was one-third lower than among lifetime nonusers (relative risk =0.66; 95 percent confidence interval, 0.44 to 0.98). Risk did not differ by duration of estrogen replacement therapy, usual dose of conjugated estrogen, or route of estrogen administration. The effects of current estrogen replacement therapy on colon cancer incidence (relative risk =0.70; 95 percent confidence interval, 0.45 to 1.09), right-sided colon cancer incidence (relative risk =0.75, 95 percent confidence interval, 0.38 to 1.48), left-sided colon cancer incidence (relative risk =0.76; 0.76; 95 percent confidence interval, 0.41 to 1.41), rectal cancer incidence (relative risk =0.52; 95 percent confidence interval, 0.21 to 1.31), and colorectal cancer mortality (relative risk =0.82; 95 percent confidence interval, 0.44 to 1.54) were similar. CONCLUSION: A reduced risk of colorectal cancer may be an additional benefit of recent estrogen replacement therapy use, which should be considered by postmenopausal women when deciding whether to use hormones.

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References

  1. Parker SL, Tong T, Bolden S, Wingo PA. Cancer statistics, 1997. CA Cancer J Clin 1997;47:5–27.

    PubMed  Google Scholar 

  2. McMichael AJ, Potter JD. Reproduction, endogenous and exogenous sex hormones, and colon cancer: a review and hypothesis. J Natl Cancer Inst 1980;65:1201–7.

    PubMed  Google Scholar 

  3. Lointier P, Wildrick DM, Boman BM. The effects of steroid hormones on a human colon cancer cell line in vitro. Anticancer Res 1992;12:1327–30.

    PubMed  Google Scholar 

  4. Burch JC, Byrd BF, Vaughn WK. The effects of long-term estrogen administration to women following hysterectomy. Front Horm Res 1975;3:208–14.

    PubMed  Google Scholar 

  5. Hammond CB, Jelovsek FR, Lee KL, Creasman WT, Parker RT. Effects of long-term estrogen replacement therapy II. Neoplasia. Am J Obstet Gynecol 1979;133:537–47.

    PubMed  Google Scholar 

  6. Nachtigall LE, Nachtigall RH, Nachtigall RD, Beckman EM. Estrogen replacement therapy II: a prospective study in the relationship to carcinoma and cardiovascular and metabolic problems. Obstet Gynecol 1979;54:74–9.

    PubMed  Google Scholar 

  7. Weiss NS, Daling JR, Chow WH. Incidence of cancer of the large bowel in women in relation to reproductive and hormonal factors. J Natl Cancer Inst 1981;67:57–60.

    PubMed  Google Scholar 

  8. Potter JD, Michael AJ. Large bowel cancer in women in relation to reproductive and hormonal factors: a case-control study. J Natl Cancer Inst 1983;71:703–9.

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  10. 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.

    PubMed  Google Scholar 

  11. Adami H-O, Persson I, Hoover R, Schairer C, Bergkvist L. Risk of cancer in women receiving hormone replacement therapy. Intl J Cancer 1989;44:833–9.

    Google Scholar 

  12. Furner SE, Davis FG, Nelson RL, Haenszel W. A case-control study of large bowel cancer and hormone exposure in women. Cancer Res 1989;49:4936–40.

    PubMed  Google Scholar 

  13. Peters RK, Pike MC, Chang WW, Mack TM. Reproductive factors and colon cancers. Br J Cancer 1990;61:741–8.

    PubMed  Google Scholar 

  14. 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.

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  17. Bostick RM, Potter JD, Kushi LH,et al. Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women (United States). Cancer Causes Control 1994;5:38–52.

    PubMed  Google Scholar 

  18. Jacobs EJ, White E, Weiss NS. Exogenous hormones, reproductive history, and colon cancer (Seattle, Washington, USA). Cancer Causes Control 1994;5:359–66.

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  21. 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.

    PubMed  Google Scholar 

  22. Newcomb PA, Storer BE. Postmenopausal hormone use and risk of large-bowel cancer. J Natl Cancer Inst 1995;87:1067–71.

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  24. Sturgeon SR, Schairer C, Brinton LA, Pearson T, Hoover RN. Evidence of a healthy estrogen user survivor effect. Epidemiology 1995;6:227–31.

    PubMed  Google Scholar 

  25. Persson I, Yuen J, Bergkvist L, Schairer C. Cancer incidence and mortality in women receiving estrogen and estrogen-progestin replacement therapy—long-term follow-up of a Swedish cohort. Int J Cancer 1996;67:327–32.

    PubMed  Google Scholar 

  26. Fernandez E, La Vecchia C, D'Avanzo B, Franceschi S, Negri E, Parazzini F. Oral contraceptives, hormone replacement therapy and the risk of colorectal cancer. Br J Cancer 1996;73:1431–5.

    PubMed  Google Scholar 

  27. 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.

    PubMed  Google Scholar 

  28. Kampman E, Potter JD, Slattery ML, Caan BJ, Edwards S. Hormone replacement therapy, reproductive history, and colon cancer: a multicenter, case-control study in the United States. Cancer Causes Control 1997;8:146–58.

    PubMed  Google Scholar 

  29. Fernandez E, La Vecchia C, Braga C,et al. Hormone replacement therapy and risk of colon and rectal cancer. Cancer Epidemiol Biomarkers Prev 1998;7:329–33.

    PubMed  Google Scholar 

  30. Grodstein F, Martinez ME, Platz EA,et al. Postmenopausal hormone use and risk for colorectal cancer and adenoma. Ann Intern Med 1998;128:705–12.

    PubMed  Google Scholar 

  31. Nanda K, Bastian LA, Hasselblad V, Simel DL. Hormone replacement therapy and the risk of colorectal cancer: a meta-analysis. Obstet Gynecol (in press).

  32. Grodstein F, Newcomb PA, Stampfer MJ. Postmenopausal hormone therapy and colorectal cancer: a review and meta-analysis. Am J Med 1999;93:880–8.

    Google Scholar 

  33. American Cancer Society. Cancer Facts & Figures. Atlanta: American Cancer Society, 1995.

    Google Scholar 

  34. Paganini-Hill A, Chao A. Accuracy of recall of hip fracture, heart attack, and cancer: a comparison of postal survey data and medical records. Am J Epidemiol 1993;138:101–6.

    PubMed  Google Scholar 

  35. Franceschi S, Bidoli E, Talamini R, Barra S, La Vecchia C. Colorectal cancer in northeast Italy: reproductive, menstrual and female hormone-related factors. Eur J Cancer 1991;27:604–8.

    PubMed  Google Scholar 

  36. Papadimitriou C, Day N, Tzonou A, Gerovassilis F, Manousos O, Trichopolos D. Biosocial correlates of colorectal cancer in Greece. Int J Epidemiol 1984;13:155–9.

    PubMed  Google Scholar 

  37. Negri E, La Vecchia C, Parazzini F,et al. Reproductive and menstrual factors and risk of colorectal cancer. Cancer Res 1989;49:7158–61.

    PubMed  Google Scholar 

  38. 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.

    PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Preventive Medicine, University of Southern California School of Medicine, 1721 Griffin Ave #205E, 90089-9680, Los Angeles, California

    Annlia Paganini-Hill Ph.D.

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  1. Annlia Paganini-Hill Ph.D.
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Additional information

This research was funded by grants from the National Institutes of Health (CA32197), the Earl Caroll Trust Fund, and Wyeth-Ayerst Laboratories.

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Paganini-Hill, A. Estrogen replacement therapy and colorectal cancer risk in elderly women. Dis Colon Rectum 42, 1300–1305 (1999). https://doi.org/10.1007/BF02234219

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  • DOI: https://doi.org/10.1007/BF02234219

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