Lingkai Xu1, Lin Li1, Dongkui Xu2, Junlan Qiu3, Qingting Feng1, Tao Wen4, Shun Lu5, Fang Meng6,7, Xiaochen Shu8. 1. Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China. 2. VIP Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. 3. Department of Oncology and Hematology, the Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou, 215153, China. 4. Medical Research Centre, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China. 5. Department of Radiation Oncology, Sichuan Cancer Hospital/Institute, University of Electronic Science and Technology of China, Chengdu, 610041, China. 6. Centre of Systems Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China. 7. Suzhou Institute of Systems Medicine, Suzhou, 215123, China. 8. Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China. xcshu@suda.edu.cn.
Abstract
BACKGROUND: Epidemiological evidence about hormone replacement therapy and colorectal carcinogenesis by demographic and clinical traits remains unclear. We aimed to assess this postulated association in a large multicentre study and further explore the modification effect by BMI and others. METHODS: We retrospectively collected records of women diagnosed with colorectal cancer (CRC) at the age of 50 years and older during 2014-2017 and their HRT dispensing prior to CRC diagnosis in three tertiary hospitals in China. CRC cases were matched with controls at a ratio of 1:3 using nearest neighbour propensity scores matching to better control for the remaining imbalance between groups, which generated a total of 824 cases with 2472 controls. RESULTS: Our study confirmed the inversed association between colorectal cancer risk and hormone replacement therapy (OR, 0.62; 95% CI, 0.54-0.75), which was more prominent among women having multiple HRT dispenses (OR, 0.60; 95% CI, 0.52-0.76). Furthermore, significant associations were consistently observed for the short-term (OR, 0.69; 95% CI, 0.57-0.88), middle-term (OR, 0.51; 95% CI, 0.41-0.66), and long-term HRT users (OR, 0.70; 95% CI, 0.43-0.90). Estrogen-related regimen reduced CRC risk more than progestogen-only. We, for the first time, found that the modifying effect of BMI on HRT use and CRC risk was in different ways when BMI was categorized by a medium level of 27. CONCLUSION: Our findings mainly suggest that there might be a different mechanism for the reversed association between HRT and colorectal tumorigenesis by BMI level, providing thoughts on clinical treatment of CRC.
BACKGROUND: Epidemiological evidence about hormone replacement therapy and colorectal carcinogenesis by demographic and clinical traits remains unclear. We aimed to assess this postulated association in a large multicentre study and further explore the modification effect by BMI and others. METHODS: We retrospectively collected records of women diagnosed with colorectal cancer (CRC) at the age of 50 years and older during 2014-2017 and their HRT dispensing prior to CRC diagnosis in three tertiary hospitals in China. CRC cases were matched with controls at a ratio of 1:3 using nearest neighbour propensity scores matching to better control for the remaining imbalance between groups, which generated a total of 824 cases with 2472 controls. RESULTS: Our study confirmed the inversed association between colorectal cancer risk and hormone replacement therapy (OR, 0.62; 95% CI, 0.54-0.75), which was more prominent among women having multiple HRT dispenses (OR, 0.60; 95% CI, 0.52-0.76). Furthermore, significant associations were consistently observed for the short-term (OR, 0.69; 95% CI, 0.57-0.88), middle-term (OR, 0.51; 95% CI, 0.41-0.66), and long-term HRT users (OR, 0.70; 95% CI, 0.43-0.90). Estrogen-related regimen reduced CRC risk more than progestogen-only. We, for the first time, found that the modifying effect of BMI on HRT use and CRC risk was in different ways when BMI was categorized by a medium level of 27. CONCLUSION: Our findings mainly suggest that there might be a different mechanism for the reversed association between HRT and colorectal tumorigenesis by BMI level, providing thoughts on clinical treatment of CRC.
Authors: Mark P Purdue; Pamela J Mink; Patricia Hartge; Wen-Yi Huang; Saundra Buys; Richard B Hayes Journal: Cancer Causes Control Date: 2005-10 Impact factor: 2.506
Authors: Lindsey A Torre; Freddie Bray; Rebecca L Siegel; Jacques Ferlay; Joannie Lortet-Tieulent; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2015-02-04 Impact factor: 508.702
Authors: Rowan T Chlebowski; Jean Wactawski-Wende; Cheryl Ritenbaugh; F Allan Hubbell; Joao Ascensao; Rebecca J Rodabough; Carol A Rosenberg; Victoria M Taylor; Randall Harris; Chu Chen; Lucile L Adams-Campbell; Emily White Journal: N Engl J Med Date: 2004-03-04 Impact factor: 91.245
Authors: P Li; J E Lin; A E Snook; A V Gibbons; D S Zuzga; S Schulz; G M Pitari; S A Waldman Journal: Clin Transl Sci Date: 2008-09 Impact factor: 4.689