ReviewPostmenopausal hormone therapy and the risk of colorectal cancer: a review and meta-analysis☆
Section snippets
Methods for quantitative overview
Through computer searches of the MEDLINE database and review of references, we sought to identify all English-language articles with quantitative data regarding the effect of postmenopausal hormone use on the risk of colorectal cancer in women. MEDLINE searches encompassed the years between January 1966 and September 1998; we identified articles using the medical-subject-headings terms “colorectal, colon, and rectal neoplasm” or textword terms “colorectal, colon, and rectal cancer” and the
Colon cancer and ever use of postmenopausal hormones
The RR of colon cancer associated with “ever” use of any postmenopausal hormone therapy, as compared with “never” users, ranged from 0.0 to 1.3 (Table 1). Thirteen of the 18 studies reported lower risks of colon cancer for ever users of postmenopausal hormones than nonusers. The summary RR was 0.80 (95% CI, 0.74 to 0.86). This point estimate was included in the CIs of all but two of the individual studies. However, there was significant heterogeneity among the studies (P = 0.02). When we
Discussion
Observational epidemiologic evidence suggests that there is a decreased risk of colorectal cancer among postmenopausal hormone users. We found a 20% reduction in cancer of the colon and a 19% reduction in cancer of the rectum among women who had ever used postmenopausal hormones compared with never users. The observed decrease was strongest among women currently taking postmenopausal hormones, in whom the risk of colorectal cancer was 34% lower than in never users. However, we found no effect
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Supported by Research Grants CA 40356 and CA 42182 from the National Institutes of Health (FG, MJS); Grant AG13482 from the National Institutes of Health (FG); and a Young Scholars Award from the Ellison Medical Foundation (FG).