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. doi: 10.1158/1055-9965.EPI-09-0596. Epub 2009 Oct 20.

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cohort Studies
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / prevention & control
  • Estrogen Replacement Therapy*
  • Female
  • Humans
  • Incidence
  • Middle Aged
  • Postmenopause*
  • Progesterone / therapeutic use*
  • Progestins / therapeutic use*
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Women's Health

Substances

  • Progestins
  • Progesterone