© 1995 by Oxford University Press
Journal of the National Cancer Institute, Vol. 87, No. 7, 517-523,
April 5, 1995
© 1995 Oxford University Press
Estrogen Replacement Therapy and Risk of Fatal Colon Cancer in a Prospective Cohort of Postmenopausal Women
Department of Epidemiology and Surveillance Research, American Cancer Society Atlanta, Ga.
Correspondence to: Eugenia E. Calle, Ph.D., American Cancer Society, 1599 Clifton Rd., N.E., Atlanta, GA 30329.
BACKGROUND:: The results of several recent epidemiologic studies suggest that estrogen replacement therapy (ERT) in postmenopausal women may decrease their risk of subsequently developing colon or colorectal cancer. However, the association is not clear, as other similar studies have failed to show this inverse relationship. Purpose: The present study attempts a more definitive analysis of the relationship between fatal colon cancer and use of ERT among women in a large prospective study of adults in the United States.
METHODS:: Women were selected for study from the 676526 female participants in Cancer Prevention Study II (CPS-II), a prospective mortality study of about 1.2 million American men and women (from all 50 states, the District of Columbia, and Puerto Rico), begun by the American Cancer Society in 1982. The median age of the female CPS-II Participants was 56 years in 1982. Vital status was determined through December 31, 1989; 630585 participants (93.2%) were still alive and 43862 (6.5%) had died after 7 years of follow-up. Death certificates were obtained for 96.2% of participants known to have died. At the end of follow-up, 897 colon cancer deaths were observed in a cohort of 422373 postmenopausal women who were cancer free at study entry. Cox proportional hazards modeling was used to compute rate ratios (RRs) and to adjust for other potential risk factors. The likelihood ratio test (two-sided) was used to determine the statistical significance of the interaction terms.
RESULTS:: Ever use of ERT was associated with significantly decreased risk of fatal colon cancer (RR = 0.71; 95% confidence interval (CI) = 0.61–0.83). The reduction in risk was strongest among current users (RR = 0.55; 95% CI = 0.40–0.76), and there was a significant (P =.0001) trend of decreasing risk with increasing years of use among all users: Users of 1 year or less had an RR of 0.81 (95% CI = 0.63–1.03), while users of 11 years or more had an RR of 0.54 (95% CI = 0.39–0.76). These associations were not altered in multivariate analyses controlling for other risk factors.
CONCLUSIONS:: In our data, estrogen therapy, particularly recent and long-term use, was associated with a substantial decrease in risk of fatal colon cancer. These results were consistent with several published studies suggesting a protective role of exogenous estrogens in the development of colorectal cancer and merit further investigation. (J Natl Cancer Inst 87: 517–523, 1995)
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. S. Hildebrand, E. J. Jacobs, P. T. Campbell, M. L. McCullough, L. R. Teras, M. J. Thun, and S. M. Gapstur Colorectal Cancer Incidence and Postmenopausal Hormone Use by Type, Recency, and Duration in Cancer Prevention Study II Cancer Epidemiol. Biomarkers Prev., November 1, 2009; 18(11): 2835 - 2841. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. G. Cleveland, S. I. Oikarinen, K. K. Bynote, M. Marttinen, J. J. Rafter, J.-A. Gustafsson, S. K. Roy, H. C. Pitot, K. S. Korach, D. B. Lubahn, et al. Disruption of estrogen receptor signaling enhances intestinal neoplasia in ApcMin/+ mice Carcinogenesis, September 1, 2009; 30(9): 1581 - 1590. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. S. CROSS, T. NITTKE, and M. PETERLIK Modulation of Vitamin D Synthesis and Catabolism in Colorectal Mucosa: A New Target for Cancer Prevention Anticancer Res, September 1, 2009; 29(9): 3705 - 3712. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. BROZEK, S. KRIWANEK, E. BONNER, M. PETERLIK, and H. S. CROSS Mutual Associations between Malignancy, Age, Gender, and Subsite Incidence of Colorectal Cancer Anticancer Res, September 1, 2009; 29(9): 3721 - 3726. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Johnson, J. V. Lacey Jr., D. Lazovich, M. A. Geller, C. Schairer, A. Schatzkin, and A. Flood Menopausal Hormone Therapy and Risk of Colorectal Cancer Cancer Epidemiol. Biomarkers Prev., January 1, 2009; 18(1): 196 - 203. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. S. Gass, S. S. Bassuk, and J. E. Manson Reassessing Benefits and Risks of Hormone Therapy American Journal of Lifestyle Medicine, January 1, 2009; 3(1): 29 - 43. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Protiva, H. S. Cross, M. E. Hopkins, E. Kallay, G. Bises, E. Dreyhaupt, L. Augenlicht, M. Lipkin, M. Lesser, E. Livote, et al. Chemoprevention of Colorectal Neoplasia by Estrogen: Potential Role of Vitamin D Activity Cancer Prevention Research, January 1, 2009; 2(1): 43 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Ritenbaugh, J. L. Stanford, L. Wu, J. M. Shikany, R. E. Schoen, M. L. Stefanick, V. Taylor, C. Garland, G. Frank, D. Lane, et al. Conjugated Equine Estrogens and Colorectal Cancer Incidence and Survival: The Women's Health Initiative Randomized Clinical Trial Cancer Epidemiol. Biomarkers Prev., October 1, 2008; 17(10): 2609 - 2618. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Nomura, L. R Wilkens, S. P Murphy, J. H Hankin, B. E Henderson, M. C Pike, and L. N Kolonel Association of vegetable, fruit, and grain intakes with colorectal cancer: the Multiethnic Cohort Study Am. J. Clinical Nutrition, September 1, 2008; 88(3): 730 - 737. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. L. Mai, J. Sullivan-Halley, G. Ursin, D. O. Stram, D. Deapen, D. Villaluna, P. L. Horn-Ross, C. A. Clarke, P. Reynolds, R. K. Ross, et al. Physical Activity and Colon Cancer Risk among Women in the California Teachers Study Cancer Epidemiol. Biomarkers Prev., March 1, 2007; 16(3): 517 - 525. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Chan, J. A. Meyerhardt, A. T. Chan, E. L. Giovannucci, G. A. Colditz, and C. S. Fuchs Hormone Replacement Therapy and Survival After Colorectal Cancer Diagnosis J. Clin. Oncol., December 20, 2006; 24(36): 5680 - 5686. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E E Frezza, M S Wachtel, and M Chiriva-Internati Influence of obesity on the risk of developing colon cancer Gut, February 1, 2006; 55(2): 285 - 291. [Full Text] [PDF]
|
|
|
|
 |
|
 V. Martineti, L. Picariello, I. Tognarini, S. C. Sala, A. Gozzini, C. Azzari, C. Mavilia, A. Tanini, A. Falchetti, G. Fiorelli, et al. ER{beta} is a potent inhibitor of cell proliferation in the HCT8 human colon cancer cell line through regulation of cell cycle components Endocr. Relat. Cancer, June 1, 2005; 12(2): 455 - 469. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S R Davis, I Dinatale, L Rivera-Woll, and S Davison Postmenopausal hormone therapy: from monkey glands to transdermal patches J. Endocrinol., May 1, 2005; 185(2): 207 - 222. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. T. Hawk and B. Levin Colorectal Cancer Prevention J. Clin. Oncol., January 10, 2005; 23(2): 378 - 391. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Bardin, N Boulle, G Lazennec, F Vignon, and P Pujol Loss of ER{beta} expression as a common step in estrogen-dependent tumor progression Endocr. Relat. Cancer, September 1, 2004; 11(3): 537 - 551. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. T. Chlebowski, J. Wactawski-Wende, C. Ritenbaugh, F. A. Hubbell, J. Ascensao, R. J. Rodabough, C. A. Rosenberg, V. M. Taylor, R. Harris, C. Chen, et al. Estrogen plus Progestin and Colorectal Cancer in Postmenopausal Women N. Engl. J. Med., March 4, 2004; 350(10): 991 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kakizoe Chemoprevention of Cancer - Focusing on Clinical Trials Jpn. J. Clin. Oncol., September 1, 2003; 33(9): 421 - 442. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Boyle and M. E. Leon Epidemiology of colorectal cancer Br. Med. Bull., December 1, 2002; 64(1): 1 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Holmes, M. N. Pollak, and S. E. Hankinson Lifestyle Correlates of Plasma Insulin-like Growth Factor I and Insulin-like Growth Factor Binding Protein 3 Concentrations Cancer Epidemiol. Biomarkers Prev., September 1, 2002; 11(9): 862 - 867. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Elsheikh, D. B. Dunger, G. S. Conway, and J. A. H. Wass Turner's Syndrome in Adulthood Endocr. Rev., February 1, 2002; 23(1): 120 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. Gruber, W. Tschugguel, C. Schneeberger, and J. C. Huber Production and Actions of Estrogens N. Engl. J. Med., January 31, 2002; 346(5): 340 - 352. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Giovannucci Insulin, Insulin-Like Growth Factors and Colon Cancer: A Review of the Evidence J. Nutr., November 1, 2001; 131(11): 3109S - 3120. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. I. Pritchard Hormone Replacement in Women with a History of Breast Cancer Oncologist, August 1, 2001; 6(4): 353 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. G. Glazier and M. A. Bowman A Review of the Evidence for the Use of Phytoestrogens as a Replacement for Traditional Estrogen Replacement Therapy Arch Intern Med, May 14, 2001; 161(9): 1161 - 1172. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Rodriguez, E. E. Calle, A. V. Patel, L. M. Tatham, E. J. Jacobs, and M. J. Thun Effect of Body Mass on the Association between Estrogen Replacement Therapy and Mortality among Elderly US Women Am. J. Epidemiol., January 15, 2001; 153(2): 145 - 152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. J. Jacobs, C. J. Connell, A. V. Patel, A. Chao, C. Rodriguez, J. Seymour, M. L. McCullough, E. E. Calle, and M. J. Thun Vitamin C and Vitamin E Supplement Use and Colorectal Cancer Mortality in a Large American Cancer Society Cohort Cancer Epidemiol. Biomarkers Prev., January 1, 2001; 10(1): 17 - 23. [Abstract] [Full Text]
|
|
|
|
|
|
Y. Zhang, D. T. Felson, R. C. Ellison, B. E. Kreger, A. Schatzkin, J. F. Dorgan, L. A. Cupples, D. Levy, and D. P. Kiel Bone Mass and the Risk of Colon Cancer among Postmenopausal Women : The Framingham Study Am. J. Epidemiol., January 1, 2001; 153(1): 31 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Chao, M. J. Thun, E. J. Jacobs, S. J. Henley, C. Rodriguez, and E. E. Calle Cigarette Smoking and Colorectal Cancer Mortality in the Cancer Prevention Study II J Natl Cancer Inst, December 6, 2000; 92(23): 1888 - 1896. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. K. Murphy, E. E. Calle, C. Rodriguez, H. S. Kahn, and M. J. Thun Body Mass Index and Colon Cancer Mortality in a Large Prospective Study Am. J. Epidemiol., November 1, 2000; 152(9): 847 - 854. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Thun, E. E. Calle, C. Rodriguez, and P. A. Wingo Epidemiological Research at the American Cancer Society Cancer Epidemiol. Biomarkers Prev., September 1, 2000; 9(9): 861 - 868. [Full Text]
|
|
|
|
|
|
P. A. Janne and R. J. Mayer Chemoprevention of Colorectal Cancer N. Engl. J. Med., June 29, 2000; 342(26): 1960 - 1968. [Full Text] [PDF]
|
|
|
|
|
|
N. Prihartono, J. R. Palmer, C. Louik, S. Shapiro, and L. Rosenberg A Case-Control Study of Use of Postmenopausal Female Hormone Supplements in Relation to the Risk of Large Bowel Cancer Cancer Epidemiol. Biomarkers Prev., April 1, 2000; 9(4): 443 - 447. [Abstract] [Full Text]
|
|
|
|
 |
|
 E. F. Foley, A. A. Jazaeri, M. A. Shupnik, O. Jazaeri, and L. W. Rice Selective Loss of Estrogen Receptor {beta} in Malignant Human Colon Cancer Res., January 1, 2000; 60(2): 245 - 248. [Abstract] [Full Text]
|
|
|
|
 |
|
 D. P. McDonnell Selective Estrogen Receptor Modulators (SERMs): A First Step in the Development of Perfect Hormone Replacement Therapy Regimen Reproductive Sciences, January 1, 2000; 7(1_suppl): S10 - S15. [Abstract] [PDF]
|
|
|
|
 |
|
 D. S. Weinberg, C. J. Newschaffer, and A. Topham Risk for Colorectal Cancer after Gynecologic Cancer Ann Intern Med, August 3, 1999; 131(3): 189 - 193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Potter Colorectal Cancer: Molecules and Populations J Natl Cancer Inst, June 2, 1999; 91(11): 916 - 932. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Fowble, A. Hanlon, G. Freedman, A. Patchefsky, H. Kessler, N. Nicolaou, J. Hoffman, E. Sigurdson, M. Boraas, and L. Goldstein Postmenopausal Hormone Replacement Therapy: Effect on Diagnosis and Outcome in Early-Stage Invasive Breast Cancer Treated With Conservative Surgery and Radiation J. Clin. Oncol., June 1, 1999; 17(6): 1680 - 1680. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. English, K. F. Kane, N. Cruickshank, M. J. S. Langman, P. M. Stewart, and M. Hewison Loss of Estrogen Inactivation in Colonic Cancer J. Clin. Endocrinol. Metab., June 1, 1999; 84(6): 2080 - 2085. [Abstract] [Full Text]
|
|
|
|
 |
|
 E. Sbarouni, Z. S. Kyriakides, and D. T. Kremastinos The effect of hormone replacement therapy alone and in combination with simvastatin on plasma lipids of hypercholesterolemic postmenopausal women with coronary artery disease J. Am. Coll. Cardiol., November 1, 1998; 32(5): 1244 - 1250. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Baron, G. B. Holzman, and J. Schulkin Attitudes of Obstetricians and Gynecologists toward Hormone Replacement Therapy Med Decis Making, October 1, 1998; 18(4): 406 - 411. [Abstract] [PDF]
|
|
|
|
|
|
M LANGMAN and P BOYLE Chemoprevention of colorectal cancer Gut, October 1, 1998; 43(4): 578 - 585. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Treatment of Estrogen Deficiency Symptoms in Women Surviving Breast Cancer J. Clin. Endocrinol. Metab., June 1, 1998; 83(6): 1993 - 2000. [Full Text]
|
|
|
|
|
|
F. Grodstein, M. J. Stampfer, G. A. Colditz, W. C. Willett, J. E. Manson, M. Joffe, B. Rosner, C. Fuchs, S. E. Hankinson, D. J. Hunter, et al. Postmenopausal Hormone Therapy and Mortality N. Engl. J. Med., June 19, 1997; 336(25): 1769 - 1776. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. F. Col, M. H. Eckman, R. H. Karas, S. G. Pauker, R. J. Goldberg, E. M. Ross, R. K. Orr, and J. B. Wong Patient-Specific Decisions About Hormone Replacement Therapy in Postmenopausal Women JAMA, April 9, 1997; 277(14): 1140 - 1147. [Abstract] [PDF]
|
|
|
|
|
|
K. A. Johnson, S. A. Prindiville, G. Morgan, D. F. Roychowdhury, A.A. van Bodegraven, J. Lourens, J.W. Sindram, H. J. Kaufmann, M. Schuler, E. Giovannucci, et al. Aspirin and the Risk of Colorectal Cancer in Women N. Engl. J. Med., January 11, 1996; 334(2): 119 - 122. [Full Text]
|
|
|
|
|
|
N. E. Davidson Hormone-Replacement Therapy -- Breast versus Heart versus Bone N. Engl. J. Med., June 15, 1995; 332(24): 1638 - 1639. [Full Text]
|
|