COLORECTAL CANCER IN RELATION TO POSTMENOPAUSAL ESTROGEN AND ESTROGEN PLUS PROGESTIN IN THE WOMEN'S HEALTH INITIATIVE CLINICAL TRIAL AND OBSERVATIONAL STUDY

BACKGROUND: Colorectal cancer incidence was reduced among women assigned to active treatment in the Women's Health Initiative (WHI) estrogen plus progestin randomized trial, but the interpretation was obscured by an associated later stage of diagnosis. In contrast the estrogen-alone trial showe...

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Main Authors: Prentice, Ross L., Pettinger, Mary, Beresford, Shirley A. A., Wactawski-Wende, Jean, Hubbell, F. Allan, Stefanick, Marcia L., Chlebowski, Rowan T.
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Jezik:English
Izdano: 2009
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Online dostop:https://ncbi.nlm.nih.gov/pmc/articles/PMC2689377/
https://ncbi.nlm.nih.gov/pubmed/19423530
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1158/1055-9965.EPI-08-1209
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spelling pubmed-26893772010-05-01 COLORECTAL CANCER IN RELATION TO POSTMENOPAUSAL ESTROGEN AND ESTROGEN PLUS PROGESTIN IN THE WOMEN'S HEALTH INITIATIVE CLINICAL TRIAL AND OBSERVATIONAL STUDY Prentice, Ross L. Pettinger, Mary Beresford, Shirley A. A. Wactawski-Wende, Jean Hubbell, F. Allan Stefanick, Marcia L. Chlebowski, Rowan T. Cancer Epidemiol Biomarkers Prev Article BACKGROUND: Colorectal cancer incidence was reduced among women assigned to active treatment in the Women's Health Initiative (WHI) estrogen plus progestin randomized trial, but the interpretation was obscured by an associated later stage of diagnosis. In contrast the estrogen-alone trial showed no incidence reduction or differential stage at diagnosis. Here, data from the WHI observational study are considered, in conjunction with colorectal cancer mortality data from the hormone therapy trials, in an attempt to clarify postmenopausal hormone therapy effects. PARTICIPANTS AND METHODS: Postmenopausal women aged 50−79 at WHI enrollment. Estrogen-alone analyses include 21,552 and 10,739 women who were post-hysterectomy from the observational study and clinical trial respectively. Estrogen plus progestin analyses include 32,084 and 16,608 observational study and clinical trial women with uterus. Colorectal cancers were verified by central medical and pathology report review. RESULTS: Hazard ratios (95% confidence intervals) from the WHI observational study were 0.80 (0.53 to 1.20) for estrogen and 1.15 (0.74 to 1.79) for estrogen plus progestin, with respectively 168 and 175 women diagnosed with colorectal cancer. Delayed diagnosis with estrogen plus progestin is not evident in the observational study. No protective effect on colorectal cancer mortality in the estrogen plus progestin trial is seen over an 8-year intervention and follow-up period. CONCLUSION: Hazard ratio patterns in the WHI clinical trial and observational study do not provide strong evidence of a clinically important colorectal cancer benefit with either estrogen-alone or estrogen plus progestin over 7−8 years of treatment and follow-up. 2009-05 /pmc/articles/PMC2689377/ /pubmed/19423530 http://dx.doi.org/10.1158/1055-9965.EPI-08-1209 Text en
institution US National Library of Medicine
collection PubMed Central
language English
format Article
topic Article
spellingShingle Article
Prentice, Ross L.
Pettinger, Mary
Beresford, Shirley A. A.
Wactawski-Wende, Jean
Hubbell, F. Allan
Stefanick, Marcia L.
Chlebowski, Rowan T.
COLORECTAL CANCER IN RELATION TO POSTMENOPAUSAL ESTROGEN AND ESTROGEN PLUS PROGESTIN IN THE WOMEN'S HEALTH INITIATIVE CLINICAL TRIAL AND OBSERVATIONAL STUDY
description BACKGROUND: Colorectal cancer incidence was reduced among women assigned to active treatment in the Women's Health Initiative (WHI) estrogen plus progestin randomized trial, but the interpretation was obscured by an associated later stage of diagnosis. In contrast the estrogen-alone trial showed no incidence reduction or differential stage at diagnosis. Here, data from the WHI observational study are considered, in conjunction with colorectal cancer mortality data from the hormone therapy trials, in an attempt to clarify postmenopausal hormone therapy effects. PARTICIPANTS AND METHODS: Postmenopausal women aged 50−79 at WHI enrollment. Estrogen-alone analyses include 21,552 and 10,739 women who were post-hysterectomy from the observational study and clinical trial respectively. Estrogen plus progestin analyses include 32,084 and 16,608 observational study and clinical trial women with uterus. Colorectal cancers were verified by central medical and pathology report review. RESULTS: Hazard ratios (95% confidence intervals) from the WHI observational study were 0.80 (0.53 to 1.20) for estrogen and 1.15 (0.74 to 1.79) for estrogen plus progestin, with respectively 168 and 175 women diagnosed with colorectal cancer. Delayed diagnosis with estrogen plus progestin is not evident in the observational study. No protective effect on colorectal cancer mortality in the estrogen plus progestin trial is seen over an 8-year intervention and follow-up period. CONCLUSION: Hazard ratio patterns in the WHI clinical trial and observational study do not provide strong evidence of a clinically important colorectal cancer benefit with either estrogen-alone or estrogen plus progestin over 7−8 years of treatment and follow-up.
author Prentice, Ross L.
Pettinger, Mary
Beresford, Shirley A. A.
Wactawski-Wende, Jean
Hubbell, F. Allan
Stefanick, Marcia L.
Chlebowski, Rowan T.
author_facet Prentice, Ross L.
Pettinger, Mary
Beresford, Shirley A. A.
Wactawski-Wende, Jean
Hubbell, F. Allan
Stefanick, Marcia L.
Chlebowski, Rowan T.
author_sort Prentice, Ross L.
title COLORECTAL CANCER IN RELATION TO POSTMENOPAUSAL ESTROGEN AND ESTROGEN PLUS PROGESTIN IN THE WOMEN'S HEALTH INITIATIVE CLINICAL TRIAL AND OBSERVATIONAL STUDY
title_short COLORECTAL CANCER IN RELATION TO POSTMENOPAUSAL ESTROGEN AND ESTROGEN PLUS PROGESTIN IN THE WOMEN'S HEALTH INITIATIVE CLINICAL TRIAL AND OBSERVATIONAL STUDY
title_full COLORECTAL CANCER IN RELATION TO POSTMENOPAUSAL ESTROGEN AND ESTROGEN PLUS PROGESTIN IN THE WOMEN'S HEALTH INITIATIVE CLINICAL TRIAL AND OBSERVATIONAL STUDY
title_fullStr COLORECTAL CANCER IN RELATION TO POSTMENOPAUSAL ESTROGEN AND ESTROGEN PLUS PROGESTIN IN THE WOMEN'S HEALTH INITIATIVE CLINICAL TRIAL AND OBSERVATIONAL STUDY
title_full_unstemmed COLORECTAL CANCER IN RELATION TO POSTMENOPAUSAL ESTROGEN AND ESTROGEN PLUS PROGESTIN IN THE WOMEN'S HEALTH INITIATIVE CLINICAL TRIAL AND OBSERVATIONAL STUDY
title_sort colorectal cancer in relation to postmenopausal estrogen and estrogen plus progestin in the women's health initiative clinical trial and observational study
publishDate 2009
url https://ncbi.nlm.nih.gov/pmc/articles/PMC2689377/
https://ncbi.nlm.nih.gov/pubmed/19423530
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1158/1055-9965.EPI-08-1209
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