Background
Methods
The malmö diet and cancer study
Exposure assessement
Study population
End-point retrieval
Tumour characteristics
Tissue microarray construction and immunohistochemistry
Statistical methods
Factor (n of subjects with information) | Category | Current CHRT n = 3051 (18.0%) | Current ERT n = 1375 (8.0%) | HRT non use n = 12519 (73.9%) | Ever OC n = 8353 (49.1%) | Never OC n = 8661 (50.1%) |
---|---|---|---|---|---|---|
Age at baseline (16990) |
Years*
|
56.7
|
59.2
|
57.6
|
53.7
|
61.0
|
p |
<0.001
|
<0.001
| ||||
Education (16947) | Not completed school | 0.2’ | 0.2 | 0.9 | 0.3 | 1.2 |
Elementary school (6–8 years) | 31.8 | 34.7 | 40.2 | 29.6 | 47.4 | |
0-level college (9–10 years) | 33.4 | 34.4 | 29.7 | 32.5 | 28.3 | |
A-level college (10–12 years) | 7.8 | 6.2 | 6.8 | 8.1 | 5.8 | |
1 year university | 8.9 | 8.6 | 8.2 | 9.9 | 6.9 | |
University degree | 17.6 | 15.9 | 14.2 | 19.5 | 10.3 | |
p | <0.001 | <0.001 | ||||
Smoking status (16984) | Yes regularly | 23.7 | 20.3 | 23.7 | 27.8 | 20.6 |
Yes occasionally | 4.8 | 4.0 | 4.2 | 4.9 | 3.8 | |
Former smoker | 31.2 | 18.0 | 26.9 | 31.6 | 25.0 | |
Never smoked | 40.0 | 44.7 | 45.2 | 35.8 | 54.2 | |
p | <0.001 | <0.001 | ||||
Alcohol consumption (16990) |
g/day*
|
9.47
|
8.65
|
7.27
|
9.3
|
6.05
|
p |
<0.001
|
<0.001
| ||||
BMI (16964) |
Kg/m
2*
|
24.8
|
25.0
|
26.6
|
24.8
|
26.0
|
p
|
<0.001
|
<0.001
|
Results
Baseline characteristics
HRT use and risk of colorectal cancer subgroups
Tumour subgroups | HRT use | Number of cases | HR crude |
p
| HR adjusted |
p
|
---|---|---|---|---|---|---|
CRC | No | 236 | 1.00 | 1.00 | ||
ERT | 24 | 0.89(0.59-1.35) |
0.583
| 0.94(0.62-1.44) |
0.788
| |
CHRT | 41 | 0.74(0.53-1.03) |
0.076
| 0.94(0.67-1.31) |
0.701
| |
T stage 1 & 2 | No | 54 | 1.00 | 1.00 | ||
ERT | 3 | 0.53(0.17-1.70) |
0.284
| 0.56(0.17-1.80) |
0.560
| |
CHRT | 3 | 0.24(0.09-0.77) |
0.016
| 0.30(0.09-0.96) |
0.043
| |
T stage 3 & 4 | No | 156 | 1.00 | 1.00 | ||
ERT | 17 | 0.93(0.56-1.52) |
0.761
| 1.01(0.61-1.67) |
0.966
| |
CHRT | 32 | 0.87(0.59-1.27) |
0.471
| 1.14(0.77-1.68) |
0.511
| |
N0 | No | 119 | 1.00 | 1.00 | ||
ERT | 14 | 1.03(0.59-1.79) |
0.912
| 1.15(0.66-2.01) |
0.615
| |
CHRT | 22 | 0.79(0.50-1.24) |
0.302
| 1.05(0.66-1.67) |
0.838
| |
N1 & N2 | No | 79 | 1.00 | 1.00 | ||
ERT | 7 | 0.75(0.35-1.63) |
0.471
| 0.78(0.36-1.68) |
0.522
| |
CHRT | 15 | 0.81(0.47-1.40) |
0.449
| 0.95(0.54-1.67) |
0.860
| |
M0 | No | 181 | 1.00 | 1.00 | ||
ERT | 20 | 0.96(0.61-1.52) |
0.863
| 1.04(0.66-1.66) |
0.861
| |
CHRT | 34 | 0.80(0.55-1.15) |
0.232
| 1.03(0.71-1.49) |
0.893
| |
M1 | No | 45 | 1.00 | 1.00 | ||
ERT | 4 | 0.78(028–2.16) |
0.632
| 0.77(0.28-2.16) |
0.625
| |
CHRT | 7 | 0.66(0.30-1.47) |
0.311
| 0.80(0.36-1.80) |
0.589
|
Tumour subgroups | HRT use | n | HR crude |
p
| HR adjusted | p |
---|---|---|---|---|---|---|
beta-catenin + | No | 126 | 1.00 | 1.00 | ||
ERT | 13 | 0.93(0.52-1.64) |
0.790
| 1.04(0.58-1.84) |
0.902
| |
CHRT | 19 | 0.64(0.40-1.04) |
0.074
| 0.87(0.53-1.42) |
0.868
| |
beta-catenin − | No | 80 | 1.00 | 1.00 | ||
ERT | 7 | 0.76(0.35-1.65) |
0.490
| 0.77(0.36-1.68) |
0.516
| |
CHRT | 13 | 0.69(0.39-1.24) |
0.217
| 0.83(0.46-1.50) |
0.533
| |
cyclin D1 + | No | 173 | 1.00 | 1.00 | ||
ERT | 16 | 0.81(0.49-1.35) |
0.416
| 0.87(0.52-145) |
0.591
| |
CHRT | 29 | 0.72(0.48-1.06) |
0.096
| 0.93(0.63-1.39) |
0.734
| |
cyclin D1 − | No | 31 | 1.00 | 1.00 | ||
ERT | 4 | 1.16(0.41-3.28) |
0.782
| 1.26(0.44-3.59) |
0.661
| |
CHRT | 5 | 0.68(0.27-1.75) |
0.425
| 0.84(0.32-2.19) |
0.721
| |
p53 + | No | 99 | 1.00 | 1.00 | ||
ERT | 11 | 0.98(0.53-1.83) |
0.956
| 1.07(0.57-1.99) |
0.843
| |
CHRT | 18 | 0.78(0.47-1.29) |
0.334
| 1.00(0.59-1.65) |
0.970
| |
p53 − | No | 107 | 1.00 | 1.00 | ||
ERT | 9 | 0.74(0.37-1.45) |
0.374
| 0.79(0.40-1.55) |
0.488
| |
CHRT | 16 | 0.63(0.38-1.07) |
0.089
| 0.84(0.49-1.42) |
0.508
| |
MSI | No | 38 | 1.00 | 1.00 | ||
ERT | 1 | 0.23(0.03-1.63) |
0.140
| 0.24(0.03-1.72) |
0.154
| |
CHRT | 5 | 0.56(0.22-1.43) |
0.225
| 0.80(0.31-2.06) |
0.649
| |
MSS | No | 164 | 1.00 | 1.00 | ||
ERT | 18 | 0.97(0.60-1.58) |
0.903
| 1.06(0.65-1.72) |
0.829
| |
CHRT | 28 | 0.73(0.49-1.09) |
0.120
| 0.92(0.61-1.39) |
0.700
|
Colon | Rectum | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Tumour subgroups | HRT use | n | HR crude |
p
| HR adjusted |
p
| n | HR crude |
p
| HR adjusted |
p
|
CRC | No | 150 | 1.00 | 1.00 | 81 | 1.00 | 1.00 | ||||
ERT | 15 | 1.21(0.71-2.06) |
0.488
| 1.17(0.67-2.02) |
0.584
| 8 | 0.49(0.23-1.03) |
0.061
| 0.38(0.17-0.86) |
0.020
| |
CHRT | 28 | 1.04(0.68-1.57) |
0.873
| 1.16(0.74-1.80) |
0.521
| 13 | 0.44(0.23-0.86) |
0.017
| 0.32(0.14-0.71) |
0.005
| |
T stage 1 & 2 | No | 27 | 1.00 | 1.00 | 24 | 1.00 | 1.00 | ||||
ERT | 1 | 0.52(0.07-3.89) |
0.525
| 0.34(0.04-2.70) |
0.308
| 2 | 0.32(0.07-1.45) |
0.138
| 0.11(0.02-0.67) |
0.017
| |
CHRT | 1 | 0.21(0.03-1.54) |
0.125
| 0.24(0.03-1.90) |
0.178
| 2 | 0.09(0.01-0.76) |
0.026
| 0.03(0.00-0.36) |
0.031
| |
T stage 3 & 4 | No | 117 | 1.00 | 1.00 | 42 | 1.00 | 1.00 | ||||
ERT | 13 | 1.29(0.73-2.30) |
0.381
| 1.30(0.72-2.35) |
0.384
| 4 | 0.53(0.19-1.48) |
0.223
| 0.51(0.17-1.55) |
0.233
| |
CHRT | 24 | 1.17(0.75-1.83) |
0.486
| 1.27(0.78-2.04) |
0.335
| 8 | 0.72(0.33-1.58) |
0.414
| 0.74(0.28-1.94) |
0.533
| |
N0 | No | 72 | 1.00 | 1.00 | 45 | 1.00 | 1.00 | ||||
ERT | 11 | 1.72(0.91-3.26) |
0.096
| 1.54(0.79-3.00) |
0.203
| 3 | 0.36(0.11-1.20) |
0.097
| 0.31(0.08-1.13) |
0.076
| |
CHRT | 16 | 1.20(0.70-2.08) |
0.508
| 1.49(0.83-2.67) |
0.183
| 6 | 0.29(0.10-0.85) |
0.024
| 0.22(0.06-0.77) |
0.222
| |
N1 & N2 | No | 64 | 1.00 | 1.00 | 18 | 1.00 | 1.00 | ||||
ERT | 4 | 0.76(0.28-2.10) |
0.596
| 0.79(0.28-2.23) |
0.659
| 3 | 1.03(0.30-3.56) |
0.959
| 1.00(0.26-3.92) |
1.000
| |
CHRT | 10 | 0.90(0.46-1.77) |
0.762
| 0.79(0.37-1.65) |
0.522
| 5 | 1.18(0.42-3.34) |
0.757
| 1.00(0.27-3.73) |
1.000
| |
M0 | No | 114 | 1.00 | 1.00 | 64 | 1.00 | 1.00 | ||||
ERT | 13 | 1.38(0.77-2.46) |
0.277
| 1.25(0.69-2.26) |
0.471
| 7 | 0.54(0.24-1.20) |
0.130
| 0.43(0.18-1.03) |
0.057
| |
CHRT | 22 | 1.10(0.69-1.74) |
0.695
| 1.21(0.74-1.97) |
0.446
| 12 | 0.54(0.29-1.09) |
0.084
| 0.42(0.18-0.98) |
0.044
| |
M1 | No | 32 | 1.00 | 1.00 | 13 | 1.00 | 1.00 | ||||
ERT | 3 | 1.04(0.32-3.40) |
0.953
| 1.24(0.37-4.16) |
0.732
| 1 | 0.31(0.04-2.48) |
0.269
| 0.32(0.03-3.24) |
0.335
| |
CHRT | 6 | 1.06(0.44-2.56) |
0.900
| 1.13(0.42-3.00) |
0.809
| 1 | 0.14(0.02-1.22) |
0.075
| 0.06(0.00-1.18) |
0.064
|
Colon | Rectum | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Tumour subgroups | HRT use | n | HR crude |
p
| HR adjusted |
p
| n | HR crude |
p
| HR adjusted |
p
|
beta-catenin + | No | 68 | 1.00 | 1.00 | 51 | 1.00 | 1.00 | ||||
ERT | 9 | 1.62(0.80-3.26) |
0.180
| 1.52(0.74-3.16) |
0.257
| 4 | 0.38(0.14-1.09) |
0.073
| 1.00(0.45-2.25) |
1.000
| |
CHRT | 11 | 0.88(0.46-1.67) |
0.696
| 0.96(0.48-1.91) |
0.910
| 8 | 0.44(0.19-1.02) |
0.054
| 1.00(0.44-2.26) |
1.000
| |
beta-catenin − | No | 64 | 1.00 | 1.00 | 17 | 1.00 | 1.00 | ||||
ERT | 4 | 0.76(0.27-2.09) |
0.588
| 0.71(0.25-1.97) |
0.506
| 3 | 0.87(0.24-3.12) |
0.833
| 1.00(0.27-3.73) |
1.000
| |
CHRT | 10 | 0.91(0.46-1.78) |
0.779
| 0.92(0.45-1.88) |
0.808
| 3 | 0.41(0.09-1.83) |
0.242
| 1.00(0.25-3.95) |
1.000
| |
cyclin D1 + | No | 120 | 1.00 | 1.00 | 50 | 1.00 | 1.00 | ||||
ERT | 10 | 1.04(0.54-1.98) |
0.917
| 0.96(0.49-1.86) |
0.895
| 6 | 0.56(0.23-1.34) |
0.189
| 0.44(0.17-1.14) |
0.091
| |
CHRT | 18 | 0.86(0.52-1.42) |
0.557
| 0.95(0.56-1.62) |
0.854
| 11 | 0.60(0.28-1.28) |
0.188
| 0.51(0.21-1.24) |
0.135
| |
cyclin D1 − | No | 15 | 1.00 | 1.00 | 16 | 1.00 | 1.00 | ||||
ERT | 3 | 2.05(0.59-7.10) |
0.260
| 2.34(0.65-8.44) |
0.196
| 1 | 0.37(0.05-2.81) |
0.334
| 0.28(0.03-2.27) |
0.232
| |
CHRT | 4 | 1.33(0.44-4.05) |
0.615
| 1.50(0.46-4.94) |
0.504
| 1 | 0.19(0.02-1.56) |
0.124
| 0.07(0.01-0.88) |
0.039
| |
p53 + | No | 54 | 1.00 | 1.00 | 40 | 1.00 | 1.00 | ||||
ERT | 6 | 1.38(0.59-3.24) |
0.454
| 1.27(0.53-3.02) |
0.588
| 5 | 0.54(0.21-1.41) |
0.208
| 1.00(0.43-2.35) |
1.000
| |
CHRT | 9 | 0.94(0.46-1.92) |
0.869
| 1.02(0.48-2.20) |
0.951
| 9 | 0.56(0.25-1.27) |
0.168
| 1.00(0.42-2.40) |
1.000
| |
p53 − | No | 82 | 1.00 | 1.00 | 26 | 1.00 | 1.00 | ||||
ERT | 7 | 1.02(0.47-2.21) |
0.968
| 0.95(0.43-2.11) |
0.903
| 2 | 0.47(0.11-2.02) |
0.308
| 0.23(0.05-1.18) |
0.078
| |
CHRT | 13 | 0.89(0.49-1.61) |
0.703
| 1.00(0.54-1.86) |
0.996
| 3 | 0.36(0.09-1.54) |
0.170
| 0.19(0.04-0.96) |
0.044
| |
MSI | No | 36 | 1.00 | 1.00 | 2 | 1.00 | 1.00 | ||||
ERT | 1 | 0.36(0.05-2.67) |
0.320
| 0.28(0.04-2.08) |
0.212
| 0 | - | - | |||
CHRT | 5 | 0.84(0.32-2.16) |
0.710
| 0.90(0.34-2.40) |
0.832
| 0 | - | - | |||
MSS | No | 97 | 1.00 | 1.00 | 64 | 1.00 | 1.00 | ||||
ERT | 11 | 1.35(0.72-2.53) |
0.349
| 1.36(0.71-2.60) |
0.352
| 7 | 0.54(0.24-1.22) |
0.138
| 1.00(0.49-2.03) |
1.000
| |
CHRT | 17 | 0.98(0.58-1.65) |
0.943
| 1.08(0.62-1.89) |
0.789
| 11 | 0.46(0.22-0.97) |
0.041
| 1.00(0.49-2.05) |
1.000
|
Oral contreceptive use and risk of colorectal cancer subgroups
Tumour subgroups | OC use | n | HR crude |
p
| HR adjusted |
p
|
---|---|---|---|---|---|---|
CRC | No | 194 | 1.00 | 1.00 | ||
OC | 107 | 0.56(0.44-0.71) |
<0.001
| 1.05(0.80-1.37) |
0.738
| |
T stage 1 & 2 | No | 45 | 1.00 | 1.00 | ||
OC | 17 | 0.39(0.22-0.68) |
0.001
| 0.69(0.37-1.28) |
0.239
| |
T stage 3 & 4 | No | 127 | 1.00 | 1.00 | ||
OC | 77 | 0.62(0.47-0.82) |
0.001
| 1.21(0.87-1.67) |
0.254
| |
N0 | No | 105 | 1.00 | 1.00 | ||
OC | 46 | 0.45(0.32-0.63) |
<0.001
| 0.82(0.56-1.22) |
0.328
| |
N1 & N2 | No | 60 | 1.00 | 1.00 | ||
OC | 45 | 0.78(0.52-1.13) |
0.176
| 1.36(0.88-2.11) |
0.173
| |
M0 | No | 150 | 1.00 | 1.00 | ||
OC | 85 | 0.58(0.44-0.75) |
<0.001
| 1.05(0.78-1.42) |
0.744
| |
M1 | No | 38 | 1.00 | 1.00 | ||
OC | 17 | 0.46(0.26-0.81) |
0.007
| 0.90(0.47-1.70) |
0.734
| |
beta-catenin+ | No | 105 | 1.00 | 1.00 | ||
OC | 51 | 0.50(0.35-0.70) |
<0.001
| 0.97(0.66-1.41) |
0.853
| |
beta-catenin− | No | 61 | 1.00 | 1.00 | ||
OC | 42 | 0.70(0.47-1.04) |
0.076
| 1.31(0.84-2.05) |
0.232
| |
cyclin D1+ | No | 138 | 1.00 | 1.00 | ||
OC | 75 | 0.55(0.42-0.74) |
<0.001
| 1.16(0.85-1.60) |
0.351
| |
cyclin D1− | No | 30 | 1.00 | 1.00 | ||
OC | 15 | 0.51(0.27-0.94) |
0.032
| 0.63(0.32-1.27) |
0.199
| |
p53+ | No | 81 | 1.00 | 1.00 | ||
OC | 46 | 0.58(0.41-0.83) |
0.003
| 1.06(0.70-1.60) |
0.744
| |
p53− | No | 88 | 1.00 | 1.00 | ||
OC | 45 | 0.52(0.36-0.74) |
<0.001
| 1.04(0.70-1.56) |
0.840
| |
MSI | No | 28 | 1.00 | 1.00 | ||
OC | 17 | 0.62(0.34-1.13) |
0.117
| 1.78(0.92-3.47) |
0.088
| |
MSS | No | 136 | 1.00 | 1.00 | ||
OC | 74 | 0.56(0.42-0.74) |
<0.001
| 0.98(0.71-1.36) |
0.912
|
Colon | Rectum | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Tumour subgroups | OC use | n | HR crude |
p
| HR adjusted |
p
| n | HR crude |
p
| HR adjusted |
p
|
CRC | No | 116 | 1.00 | 1.00 | 69 | 1.00 | 1.00 | ||||
OC | 59 | 1.00(0.73-1.37) |
0.998
| 1.41(0.96-2.08) |
0.080
| 37 | 1.02(0.68-1.53) |
0.934
| 0.97(0.59-1.60) |
0.900
| |
T stage 1&2 | No | 22 | 1.00 | 1.00 | 21 | 1.00 | 1.00 | ||||
OC | 8 | 0.72(0.32-1.62) |
0.422
| 1.43(0.56-3.66) |
0.462
| 8 | 0.76(0.33-1.76) |
0.521
| 0.67(0.23-1.89) |
0.445
| |
T stage 3 &4 | No | 89 | 1.00 | 1.00 | 34 | 1.00 | 1.00 | ||||
OC | 49 | 1.08(0.76-1.54) |
0.655
| 1.43(0.93-2.22) |
0.107
| 24 | 1.22(0.72-2.07) |
0.460
| 1.27(0.64-2.53) |
0.488
| |
N0 | No | 63 | 1.00 | 1.00 | 37 | 1.00 | 1.00 | ||||
OC | 26 | 0.77(0.49-1.22) |
0.271
| 1.17(0.67-2.03) |
0.582
| 18 | 0.93(0.52-1.66) |
0.811
| 0.90(0.43-1.88) |
0.780
| |
N1 & N2 | No | 43 | 1.00 | 1.00 | 17 | 1.00 | 1.00 | ||||
OC | 30 | 1.38(0.86-2.20) |
0.181
| 1.81(1.00-3.28) |
0.051
| 12 | 1.20(0.57-2.52) |
0.630
| 1.00(0.39-2.56) |
1.000
| |
M0 | No | 88 | 1.00 | 1.00 | 57 | 1.00 | 1.00 | ||||
OC | 47 | 1.05(0.73-1.49) |
0.804
| 1.55(1.00-2.40) |
0.050
| 31 | 1.00(0.64-1.56) |
0.999
| 0.83(0.47-1.45) |
0.507
| |
M1 | No | 26 | 1.00 | 1.00 | 9 | 1.00 | 1.00 | ||||
OC | 12 | 0.90(0.45-1.80) |
0.771
| 0.96(0.41-2.30) |
0.955
| 5 | 1.09(0.35-3.36) |
0.880
| 1.75(0.44-6.86) |
0.425
| |
beta-catenin+ | No | 56 | 1.00 | 1.00 | 43 | 1.00 | 1.00 | ||||
OC | 24 | 0.84(0.52-1.37) |
0.489
| 1.36(0.75-2.47) |
0.308
| 24 | 1.02(0.62-1.70) |
0.931
| 1.00(0.53-1.88) |
1.000
| |
beta-catenin− | No | 45 | 1.00 | 1.00 | 14 | 1.00 | 1.00 | ||||
OC | 29 | 1.27(0.79-2.03) |
0.322
| 1.70(0.97-3.00) |
0.065
| 10 | 1.41(0.61-3.24) |
0.421
| 1.00(0.35-2.87) |
1.000
| |
cyclin D1+ | No | 88 | 1.00 | 1.00 | 44 | 1.00 | 1.00 | ||||
OC | 46 | 1.04(0.72-1.47) |
0.843
| 1.62(1.04-2.51) |
0.032
| 24 | 1.06(0.64-1.76) |
0.826
| 1.04(0.56-1.95) |
0.893
| |
cyclin D1− | No | 15 | 1.00 | 1.00 | 14 | 1.00 | 1.00 | ||||
OC | 8 | 1.00(0.42-2.36) |
0.999
| 0.90(0.31-2.60) |
0.844
| 7 | 0.82(0.33-2.03) |
0.666
| 0.77(0.24-2.48) |
0.660
| |
p53+ | No | 45 | 1.00 | 1.00 | 32 | 1.00 | 1.00 | ||||
OC | 20 | 0.90(0.52-1.53) |
0.685
| 1.28(0.67-2.45) |
0.451
| 22 | 1.37(0.78-2.39) |
0.274
| 1.00(0.49-2.02) |
1.000
| |
p53− | No | 59 | 1.00 | 1.00 | 26 | 1.00 | 1.00 | ||||
OC | 34 | 1.11(0.73-1.70) |
0.625
| 1.54(0.90-2.63) |
0.115
| 9 | 0.59(0.28-1.27) |
0.177
| 0.52(0.21-1.30) |
0.161
| |
MSI | No | 25 | 1.00 | 1.00 | 2 | 1.00 | 1.00 | ||||
OC | 14 | 1.08(0.56-2.09) |
0.809
| 1.85(0.82-1.18) |
0.139
| 0 | - | - | |||
MSS | No | 76 | 1.00 | 1.00 | 54 | 1.00 | 1.00 |
1.000
| |||
OC | 39 | 1.02(0.69-1.50) |
0.938
| 1.43(0.89-2.32) |
0.143
| 32 | 1.10(0.70-1.72) |
0.678
| 1.00(0.58-1.74) |