Effect of hormone replacement therapy on survival in women with lung cancer

Abstract

7211 Background: Lung cancer is the leading cause of cancer-related death in women. Hormone replacement therapy (HRT) is frequently prescribed to post-menopausal women, with an estimated 12.9 million prescriptions in the last quarter of 2003. There is however, little data on the effect of HRT on lung cancer. Hence we conducted a retrospective study of women with lung cancer in order to examine the impact of HRT on the natural history of lung cancer. Methods: We conducted a retrospective review of women diagnosed with lung cancer between January 1994 and December 1999. Data collected included age of the patient, stage at presentation, past history of cancer, smoking history, family history of cancer, use of HRT, treatment for lung cancer and overall survival. The effects of various clinical features on survival were examined using Cox proportional-hazards regression models. Results: Four hundred and ninety-eight women with lung cancer were included in this study. The median age of the patients was 67 years (range, 31–93 years). Three hundred and eighty patients (76%) had non-small cell lung cancer, while 24% had small cell lung cancer. A history of smoking (past or current) was present in 429 women (86%). Two hundred and twenty-two patients (45%) presented with respiratory complaints. Eighty-six women (17%) had taken hormone replacement therapy during their lifetime. Women who received HRT developed lung cancer at a younger age as compared to those who never received HRT (63 years vs. 68 years; p < 0.0001). Also, overall survival was significantly longer in patients with no HRT (79 months vs. 39 months) (p = 0.002; HR-1.97; 95%CI 1.14–3.39: log-rank test). This effect seemed to be more pronounced in women with a history of smoking (Table). Conclusions: Women with lung cancer using HRT seem to develop the disease at a younger age and have a worse prognosis than those who never used HRT. Hence, pending future studies, HRT should be used with caution, especially in women with a history of smoking. No significant financial relationships to disclose.