Unopposed estrogen and estrogen plus progestin menopausal hormone therapy and lung cancer risk in the NIH-AARP Diet and Health Study Cohort
Unopposed estrogen and estrogen plus progestin menopausal hormone therapy and lung cancer risk in the NIH-AARP Diet and Health Study Cohort
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DOI：
10.1007/s10552-012-9904-2
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发表时间：
2012-03-01
影响因子：
2.3
通讯作者：
Gierach, Gretchen L.
中科院分区：
文献类型：
--
作者：
Brinton, Louise A.;Schwartz, Lauren;Gierach, Gretchen L.
先前的研究报道，肺癌风险可能降低、增加或不受既往使用绝经期激素治疗（MHT）的影响。为了进一步评估这一问题，我们研究了1995-1996年NIH-AARP饮食与健康研究招募的118,008名年龄在50-71岁之间的女性的关系，并在2006年的随访中发现了2,097例肺癌。多变量Cox比例风险模型估计了相对风险（RR）和95%置信区间（CIs）与自我报告的MHT使用的各种测量相关。我们没有发现任何证据表明单独使用雌激素治疗（ET）或雌激素加黄体酮治疗（EPT）与随后的肺癌风险有实质性关系（每次使用的rr和95% ci分别为0.97、0.86-1.09和1.03、0.90-1.17）。两种制剂的使用币种或持续时间没有显著差异，也没有证据表明风险在吸烟或体型界定的亚组中有所不同。几乎对所有肺癌亚型都没有效果，除了长期仅使用et会增加未分化/大细胞癌的风险（p（趋势）= 0.02），在EPT使用者中没有观察到这种关系。即使考虑了详细的暴露测量和其他风险预测因素，我们的结果也未能支持与使用无对抗雌激素或雌激素加黄体酮MHT相关的肺癌风险的任何实质性改变。
Previous studies have reported that lung cancer risk may be decreased, increased, or unaffected by prior use of menopausal hormone therapy (MHT).To assess this issue further, we examined relationships among 118,008 women, ages 50-71 years who were recruited during 1995-1996 for the NIH-AARP Diet and Health Study and in whom 2,097 incident lung carcinomas were identified during follow-up through 2006. Multivariable Cox proportional hazards models estimated relative risks (RR) and 95% confidence intervals (CIs) associated with various measures of self-reported MHT use.We found no evidence that either estrogen therapy (ET)-only or estrogen plus progestin therapy (EPT) use was substantially related to subsequent lung cancer risk (respective RRs and 95% CIs for ever use = 0.97, 0.86-1.09 and 1.03, 0.90-1.17). There were no significant variations according to currency or duration of use of either formulation, nor was there evidence that risks varied within subgroups defined by cigarette smoking or body size. The absence of effect was seen for nearly all lung cancer subtypes, with the exception of an increased risk of undifferentiated/large cell cancers associated with long-term ET-only use (p (trend) = 0.02), a relationship not observed among EPT users.Our results failed to support any substantial alterations in lung cancer risk associated with use of either unopposed estrogen or estrogen plus progestin MHT, even when detailed exposure measures and other risk predictors were considered.