Genetic risk impacts the association of menopausal hormone therapy with colorectal cancer risk

Yu Tian^#^{1

2}, Yi Lin^#³, Conghui Qu³, Volker Arndt⁴, James W Baurley^{5

6}, Sonja I Berndt⁷, Stephanie A Bien³, D Timothy Bishop⁸, Hermann Brenner^{4

9

10}, Daniel D Buchanan^{11

12

13}, Arif Budiarto⁵, Peter T Campbell¹⁴, Robert Carreras-Torres^{15

16

17

18}, Graham Casey¹⁹, Andrew T Chan^{20

21

22

23

24

25}, Rui Chen¹, Xuechen Chen⁴, David V Conti²⁶, Virginia Díez-Obrero^{15

16

17}, Niki Dimou²⁷, David A Drew^{20

21}, Jane C Figueiredo^{28

29}, Steven Gallinger³⁰, Graham G Giles^{31

32

33}, Stephen B Gruber³⁴, Marc J Gunter^{27

35}, Sophia Harlid³⁶, Tabitha A Harrison³, Akihisa Hidaka³, Michael Hoffmeister⁴, Jeroen R Huyghe³, Mark A Jenkins³¹, Kristina M Jordahl^{3

37}, Amit D Joshi²⁴, Temitope O Keku³⁸, Eric Kawaguchi²⁶, Andre E Kim²⁶, Anshul Kundaje^{39

40}, Susanna C Larsson⁴¹, Loic Le Marchand⁴², Juan Pablo Lewinger²⁶, Li Li⁴³, Victor Moreno^{15

16

17

44}, John Morrison²⁶, Neil Murphy²⁷, Hongmei Nan^{45

46}, Rami Nassir⁴⁷, Polly A Newcomb^{3

37}, Mireia Obón-Santacana^{15

16

17}, Shuji Ogino^{23

24

48

49}, Jennifer Ose^{50

51

52}, Bens Pardamean⁵, Andrew J Pellatt⁵³, Anita R Peoples^{50

51}, Elizabeth A Platz⁵⁴, John D Potter^{3

37

55}, Ross L Prentice^{3

56}, Gad Rennert^{57

58

59}, Edward A Ruiz-Narvaez⁶⁰, Lori C Sakoda^{3

61}, Robert E Schoen⁶², Anna Shcherbina⁶³, Mariana C Stern²⁹, Yu-Ru Su^{3

64}, Stephen N Thibodeau⁶⁵, Duncan C Thomas²⁶, Konstantinos K Tsilidis^{35

66}, Franzel J B van Duijnhoven⁶⁷, Bethany Van Guelpen^{36

68}, Kala Visvanathan⁵⁴, Emily White^{3

37}, Alicja Wolk⁴¹, Michael O Woods⁶⁹, Anna H Wu²⁹, Ulrike Peters^{3

37}, W James Gauderman²⁶, Li Hsu^{70

71}, Jenny Chang-Claude^{72

73}

Affiliations

¹ School of Public Health, Capital Medical University, Beijing, China.
² Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
³ Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
⁴ Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
⁵ Bioinformatics and Data Science Research Center, Bina Nusantara University, Jakarta, Indonesia.
⁶ BioRealm LLC, Walnut, CA, USA.
⁷ Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
⁸ Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.
⁹ Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.
¹⁰ German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
¹¹ Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia.
¹² University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, VIC, 3010, Australia.
¹³ Genomic Medicine and Family Cancer Clinic, The Royal Melbourne Hospital, Parkville, VIC, Australia.
¹⁴ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
¹⁵ Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
¹⁶ Oncology Data Analytics Program, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.
¹⁷ Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
¹⁸ Digestive Diseases and Microbiota Group, Girona Biomedical Research Institute Dr Josep Trueta (IDIBGI), Salt, 17190, Girona, Spain.
¹⁹ Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA.
²⁰ Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
²¹ Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
²² Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
²³ Broad Institute of Harvard and MIT, Cambridge, MA, USA.
²⁴ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
²⁵ Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
²⁶ Division of Biostatistics, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
²⁷ Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.
²⁸ Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
²⁹ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
³⁰ Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
³¹ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
³² Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.
³³ Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
³⁴ Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA.
³⁵ Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
³⁶ Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden.
³⁷ Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
³⁸ Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA.
³⁹ Department of Genetics, Stanford University, Stanford, CA, USA.
⁴⁰ Department of Computer Science, Stanford University, Stanford, CA, USA.
⁴¹ Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
⁴² University of Hawaii Cancer Center, Honolulu, HI, USA.
⁴³ Department of Family Medicine, University of Virginia, Charlottesville, VA, USA.
⁴⁴ Department of Clinical Sciences, Faculty of Medicine and health Sciences and Universitat de Barcelona Institute of Complex Systems (UBICS), University of Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain.
⁴⁵ Department of Global Health, Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA.
⁴⁶ Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indianapolis, Indianapolis, IN, USA.
⁴⁷ Department of Pathology, School of Medicine, Umm Al-Qura'a University, Mecca, Saudi Arabia.
⁴⁸ Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁴⁹ Tokyo Medical and Dental University (Institute of Science Tokyo), Tokyo, Japan.
⁵⁰ Huntsman Cancer Institute, Salt Lake City, UT, USA.
⁵¹ Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
⁵² Hochschule Hannover, University of Applied Sciences and Arts, Department III: Media, Information and Design, Hannover, Germany.
⁵³ Department of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
⁵⁴ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵⁵ Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.
⁵⁶ Department of Biostatistics, University of Washington, Seattle, WA, USA.
⁵⁷ Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel.
⁵⁸ Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
⁵⁹ Clalit National Cancer Control Center, Haifa, Israel.
⁶⁰ Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
⁶¹ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
⁶² Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁶³ Biomedical Informatics Program, Department of Biomedical Data Sciences, Stanford University, Stanford, CA, USA.
⁶⁴ Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
⁶⁵ Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
⁶⁶ Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
⁶⁷ Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
⁶⁸ Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden.
⁶⁹ Memorial University of Newfoundland, Discipline of Genetics, St. John's, NL, Canada.
⁷⁰ Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. lih@fredhutch.org.
⁷¹ Department of Biostatistics, University of Washington, Seattle, WA, USA. lih@fredhutch.org.
⁷² Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. j.chang-claude@dkfz.de.
⁷³ University Cancer Centre Hamburg (UCCH), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. j.chang-claude@dkfz.de.

^# Contributed equally.

PMID: 38561434
PMCID: PMC11091089
DOI: 10.1038/s41416-024-02638-2

Genetic risk impacts the association of menopausal hormone therapy with colorectal cancer risk

Yu Tian et al. Br J Cancer. 2024 Jun.

. 2024 Jun;130(10):1687-1696.

doi: 10.1038/s41416-024-02638-2. Epub 2024 Apr 1.

Authors

Affiliations

¹ School of Public Health, Capital Medical University, Beijing, China.
² Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
³ Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
⁴ Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
⁵ Bioinformatics and Data Science Research Center, Bina Nusantara University, Jakarta, Indonesia.
⁶ BioRealm LLC, Walnut, CA, USA.
⁷ Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
⁸ Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.
⁹ Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.
¹⁰ German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
¹¹ Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia.
¹² University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, VIC, 3010, Australia.
¹³ Genomic Medicine and Family Cancer Clinic, The Royal Melbourne Hospital, Parkville, VIC, Australia.
¹⁴ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
¹⁵ Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
¹⁶ Oncology Data Analytics Program, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.
¹⁷ Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
¹⁸ Digestive Diseases and Microbiota Group, Girona Biomedical Research Institute Dr Josep Trueta (IDIBGI), Salt, 17190, Girona, Spain.
¹⁹ Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA.
²⁰ Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
²¹ Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
²² Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
²³ Broad Institute of Harvard and MIT, Cambridge, MA, USA.
²⁴ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
²⁵ Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
²⁶ Division of Biostatistics, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
²⁷ Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.
²⁸ Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
²⁹ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
³⁰ Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
³¹ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
³² Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.
³³ Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
³⁴ Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA.
³⁵ Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
³⁶ Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden.
³⁷ Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
³⁸ Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA.
³⁹ Department of Genetics, Stanford University, Stanford, CA, USA.
⁴⁰ Department of Computer Science, Stanford University, Stanford, CA, USA.
⁴¹ Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
⁴² University of Hawaii Cancer Center, Honolulu, HI, USA.
⁴³ Department of Family Medicine, University of Virginia, Charlottesville, VA, USA.
⁴⁴ Department of Clinical Sciences, Faculty of Medicine and health Sciences and Universitat de Barcelona Institute of Complex Systems (UBICS), University of Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain.
⁴⁵ Department of Global Health, Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA.
⁴⁶ Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indianapolis, Indianapolis, IN, USA.
⁴⁷ Department of Pathology, School of Medicine, Umm Al-Qura'a University, Mecca, Saudi Arabia.
⁴⁸ Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁴⁹ Tokyo Medical and Dental University (Institute of Science Tokyo), Tokyo, Japan.
⁵⁰ Huntsman Cancer Institute, Salt Lake City, UT, USA.
⁵¹ Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
⁵² Hochschule Hannover, University of Applied Sciences and Arts, Department III: Media, Information and Design, Hannover, Germany.
⁵³ Department of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
⁵⁴ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵⁵ Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.
⁵⁶ Department of Biostatistics, University of Washington, Seattle, WA, USA.
⁵⁷ Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel.
⁵⁸ Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
⁵⁹ Clalit National Cancer Control Center, Haifa, Israel.
⁶⁰ Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
⁶¹ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
⁶² Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁶³ Biomedical Informatics Program, Department of Biomedical Data Sciences, Stanford University, Stanford, CA, USA.
⁶⁴ Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
⁶⁵ Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
⁶⁶ Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
⁶⁷ Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
⁶⁸ Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden.
⁶⁹ Memorial University of Newfoundland, Discipline of Genetics, St. John's, NL, Canada.
⁷⁰ Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. lih@fredhutch.org.
⁷¹ Department of Biostatistics, University of Washington, Seattle, WA, USA. lih@fredhutch.org.
⁷² Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. j.chang-claude@dkfz.de.
⁷³ University Cancer Centre Hamburg (UCCH), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. j.chang-claude@dkfz.de.

^# Contributed equally.

PMID: 38561434
PMCID: PMC11091089
DOI: 10.1038/s41416-024-02638-2

Abstract

Background: Menopausal hormone therapy (MHT), a common treatment to relieve symptoms of menopause, is associated with a lower risk of colorectal cancer (CRC). To inform CRC risk prediction and MHT risk-benefit assessment, we aimed to evaluate the joint association of a polygenic risk score (PRS) for CRC and MHT on CRC risk.

Methods: We used data from 28,486 postmenopausal women (11,519 cases and 16,967 controls) of European descent. A PRS based on 141 CRC-associated genetic variants was modeled as a categorical variable in quartiles. Multiplicative interaction between PRS and MHT use was evaluated using logistic regression. Additive interaction was measured using the relative excess risk due to interaction (RERI). 30-year cumulative risks of CRC for 50-year-old women according to MHT use and PRS were calculated.

Results: The reduction in odds ratios by MHT use was larger in women within the highest quartile of PRS compared to that in women within the lowest quartile of PRS (p-value = 2.7 × 10^-8). At the highest quartile of PRS, the 30-year CRC risk was statistically significantly lower for women taking any MHT than for women not taking any MHT, 3.7% (3.3%-4.0%) vs 6.1% (5.7%-6.5%) (difference 2.4%, P-value = 1.83 × 10^-14); these differences were also statistically significant but smaller in magnitude in the lowest PRS quartile, 1.6% (1.4%-1.8%) vs 2.2% (1.9%-2.4%) (difference 0.6%, P-value = 1.01 × 10^-3), indicating 4 times greater reduction in absolute risk associated with any MHT use in the highest compared to the lowest quartile of genetic CRC risk.

Conclusions: MHT use has a greater impact on the reduction of CRC risk for women at higher genetic risk. These findings have implications for the development of risk prediction models for CRC and potentially for the consideration of genetic information in the risk-benefit assessment of MHT use.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1. Effects of polygenic risk score and menopausal hormone therapy on colorectal cancer risk.**
*PRS.Q* the quartiles of polygenic risk score, OR odds ratio, 95%CI 95% confidence interval, *CRC* colorectal cancer, *MHT* menopausal hormone therapy, *RERI* the relative excess risk due to interaction. The regression model was adjusted for age, BMI, study center, and the first three principal components.

**Fig. 2. The 30-year cumulative risk estimates (%) of CRC for 50-year-old women, according to any MHT use and quartiles of PRS.**
*CRC* colorectal cancer, *PRS.Q* the quartiles of polygenic risk score, *MHT* menopausal hormone therapy.

See this image and copyright information in PMC

References

1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71:209–49. doi: 10.3322/caac.21660. - DOI - PubMed
1. Huyghe JR, Bien SA, Harrison TA, Kang HM, Chen S, Schmit SL, et al. Discovery of common and rare genetic risk variants for colorectal cancer. Nat Genet. 2019;51:76–87. doi: 10.1038/s41588-018-0286-6. - DOI - PMC - PubMed
1. Lu Y, Kweon SS, Cai Q, Tanikawa C, Shu XO, Jia WH, et al. Identification of Novel Loci and New Risk Variant in Known Loci for Colorectal Cancer Risk in East Asians. Cancer Epidemiol Biomark Prev. 2020;29:477–86. doi: 10.1158/1055-9965.EPI-19-0755. - DOI - PMC - PubMed
1. Schmit SL, Edlund CK, Schumacher FR, Gong J, Harrison TA, Huyghe JR, et al. Novel Common Genetic Susceptibility Loci for Colorectal Cancer. J Natl Cancer Inst. 2019;111:146–57. doi: 10.1093/jnci/djy099. - DOI - PMC - PubMed
1. Crouch DJM, Bodmer WF. Polygenic inheritance, GWAS, polygenic risk scores, and the search for functional variants. Proc Natl Acad Sci. 2020;117:18924. doi: 10.1073/pnas.2005634117. - DOI - PMC - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Genetic risk impacts the association of menopausal hormone therapy with colorectal cancer risk

Affiliations

Genetic risk impacts the association of menopausal hormone therapy with colorectal cancer risk

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical