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. 2017 Nov 15;7(11):e017639.
doi: 10.1136/bmjopen-2017-017639.

Menopausal hormone therapy and colorectal cancer: a linkage between nationwide registries in Norway

Edoardo Botteri  1   2 , Nathalie C Støer  1 , Solveig Sakshaug  3 , Sidsel Graff-Iversen  4 , Siri Vangen  1   5 , Solveig Hofvind  6   7 , Thomas de Lange  2 , Vincenzo Bagnardi  8 , Giske Ursin  9   10   11 , Elisabete Weiderpass  12   13   14   15
Affiliations

Menopausal hormone therapy and colorectal cancer: a linkage between nationwide registries in Norway

Edoardo Botteri et al. BMJ Open. .

Abstract

Objectives: With the present study, we aimed to investigate the association between menopausal hormone therapy (HT) and risk of colorectal cancer (CRC).

Setting: Cohort study based on the linkage of Norwegian population-based registries.

Participants: We selected 466822 Norwegian women, aged 55-79, alive and residing in Norway as of 1 January 2004, and we followed them from 2004 to 2008. Each woman contributed person-years at risk as non-user, current user and/or past HT user.

Outcome measures: The outcome of interest was adenocarcinoma of the colorectal tract, overall, by anatomic site and stage at diagnosis. Incidence rate ratios (RRs) with 95% CIs were estimated by Poisson regression and were used to evaluate the association between HT and CRC incidence.

Results: During the median follow-up of 4.8 years, 138 655 (30%) women received HT and 3799 (0.8%) incident CRCs occurred. Current, but not past, use of HT was associated with a lower risk of CRC (RR 0.88; 95% CI 0.80 to 0.98). RRs for localised, regionally advanced and metastatic CRC were 1.13 (95% CI 0.91 to 1.41), 0.81 (95% CI 0.70 to 0.94) and 0.79 (95% CI 0.62 to 1.00), respectively. RRs for current use of oestrogen therapy (ET) were 0.91 (95% CI 0.80 to 1.04) while RR for current use of combined oestrogen-progestin therapy (EPT) was 0.85 (95% CI 0.70 to 1.03), as compared with no use of HT. The same figures for ET and EPT in oral formulations were 0.83 (95% CI 0.68 to 1.03) and 0.86 (95% CI 0.71 to 1.05), respectively.

Conclusions: In our nationwide cohort study, HT use lowered the risk of CRC, specifically the most advanced CRC.

Keywords: colorectal cancer; estrogens; menopausal hormone therapy; progestins.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Follow-up of study participants.
See this image and copyright information in PMC

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