Reproductive and hormonal factors and mortality among women with colorectal cancer in the NIH-AARP Diet and Health Study.
Reproductive and hormonal factors and mortality among women with colorectal cancer in the NIH-AARP Diet and Health Study.
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DOI：
10.1038/bjc.2015.224
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发表时间：
2015-07-28
影响因子：
8.8
通讯作者：
Gunter MJ
中科院分区：
文献类型：
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作者：
Arem H;Park Y;Felix AS;Zervoudakis A;Brinton LA;Matthews CE;Gunter MJ
虽然更年期激素治疗(MHT)和一些生殖因素的使用与结直肠癌(CRC)的风险有关，但这些因素与CRC诊断后的生存率之间的关系尚不清楚。在NIH-AARP饮食与健康研究中诊断为偶发结直肠癌的2053名绝经后妇女中，我们使用多变量COX比例风险回归计算了风险比(HR)和95%可信区间(CI)，以测试口服避孕药(OC)的使用、月经初潮年龄、第一胎年龄、产次、绝经年龄和MHT使用与全原因和结直肠癌特定死亡率之间的关系。在7.7年的中位数随访期间，共有759例死亡(332例与结直肠癌相关的死亡)。我们没有观察到OC使用、月经初潮年龄、第一胎年龄、产次、绝经年龄和死亡率之间有统计学意义的相关性。与从不使用MHT相比，既往使用MHT与死亡率无关，但我们发现，在所有原因(HR=0.79，95%CI 0.66-0.94)和CRC死亡率(0.76，0.59-0.99)中，基线现有用户之间存在负相关。未来的研究应进一步关注外源性雌激素暴露可能影响肿瘤进展和结直肠癌生存的机制。
Although use of menopausal hormone therapy (MHT) and some reproductive factors have been associated with colorectal cancer (CRC) risk, relations between these factors and survival after CRC diagnosis are unclear. Among 2053 post-menopausal women diagnosed with incident CRC in the NIH-AARP Diet and Health Study, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using multivariable Cox proportional hazards regression to test associations between oral contraceptive (OC) use, menarche age, age at first birth, parity, menopausal age, and MHT use with all-cause and CRC-specific mortality. There were 759 deaths (332 CRC-related deaths) over a median follow-up of 7.7 years. We observed no statistically significant associations between OC use, menarche age, age at first birth, parity, menopausal age, and mortality. Compared with never MHT use, former use was not associated with mortality, but we found an inverse association among baseline current users, for both all-cause (HR=0.79, 95% CI 0.66–0.94) and CRC mortality (0.76, 0.59–0.99). Future studies should further focus on the mechanisms by which exogenous oestrogen exposure might affect tumour progression and CRC survival.