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12.01.2016 | CANCER | Ausgabe 5/2016

European Journal of Epidemiology 5/2016

The influence of hormone therapies on colon and rectal cancer

European Journal of Epidemiology > Ausgabe 5/2016
Lina Steinrud Mørch, Øjvind Lidegaard, Niels Keiding, Ellen Løkkegaard, Susanne Krüger Kjær
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The online version of this article (doi:10.​1007/​s10654-016-0116-z) contains supplementary material, which is available to authorized users.
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Exogenous sex hormones seem to play a role in colorectal carcinogenesis. Little is known about the influence of different types or durations of postmenopausal hormone therapy (HT) on colorectal cancer risk. A nationwide cohort of women 50–79 years old without previous cancer (n = 1,006,219) were followed 1995–2009. Information on HT exposures was from the National Prescription Register and updated daily, while information on colon (n = 8377) and rectal cancers (n = 4742) were from the National Cancer Registry. Potential confounders were obtained from other national registers. Poisson regression analyses with 5-year age bands included hormone exposures as time-dependent covariates. Use of estrogen-only therapy and combined therapy were associated with decreased risks of colon cancer (adjusted incidence rate ratio 0.77, 95 % confidence interval 0.68–0.86 and 0.88, 0.80–0.96) and rectal cancer (0.83, 0.72–0.96 and 0.89, 0.80–1.00), compared to never users. Transdermal estrogen-only therapy implied more protection than oral administration, while no significant influence was found of regimen, progestin type, nor of tibolone. The benefit of HT was stronger for long-term hormone users; and hormone users were at lower risk of advanced stage of colorectal cancer, which seems supportive for a causal association between hormone therapy and colorectal cancer.

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