Abstract
BackgroundThe effect of menopausal hormone therapy (MHT) on gastrointestinal (GI) cancers is controversial, and no research has been conducted in the East. This study investigates the association between MHT and GI cancer risks in South Korea.MethodsA prescription-based cohort study was conducted using the NHIS Sample Cohort (2002–2013) of Korea. We used 1:5 propensity score matching, and 22,577 MHT users and 111,113 non-users were selected. Kaplan–Meier survival curves with log-rank tests were used. Cox proportional hazard models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Landmark analysis was used to determine dose–response relationship.ResultsThe median follow-up was 79.6 of months. Kaplan–Meier survival curve showed less frequent GI cancer diagnoses in MHT users compared to non-users (0.13 vs. 0.16 per 100,000 person-years). Menopausal hormone therapy was associated with decreased incidence of GI cancer (HR = 0.809, 95%CI = 0.691–0.946) and colorectal cancer (CRC) (HR = 0.757, 95%CI = 0.577–0.995). Gastric cancer (GC) incidence showed marginal significance (HR = 0.787, 95%CI = 0.605–1.023). The mortality from GI cancer was lower in MHT users than in non-users (HR = 0.737, 95%CI = 0.547–0.993). The relationship between MHT and GI cancer was stronger with increasing MHT dose in terms of both incidence (Ptrend = 0.0002) and mortality (Ptrend = 0.0064).ConclusionsThe association between MHT use and reduced risks of GI cancers was attributed to CRC and GC and showed a dose–response relationship in a population-based cohort study.
Highlights
The effect of menopausal hormone therapy (MHT) on gastrointestinal (GI) cancers is controversial, and no research has been conducted in the East
The aim of the study was to determine the association between MHT use and GI cancer risks, to identify how they differ by MHT regimen or baseline characteristics, and whether there is a dose–response relationship
Cancer incidence: univariate analyses During the study period, 4756 (0.57 per 100,000 personyears) subjects were diagnosed with any type of cancer, which did not differ between MHT users and non-users (0.60 vs. 0.57, P = 0.1699) (Table 2)
Summary
The effect of menopausal hormone therapy (MHT) on gastrointestinal (GI) cancers is controversial, and no research has been conducted in the East. Nam et al BMC Gastroenterology (2021) 21:440 are more prevalent in men than women [1], its prevalence rapidly increases with age, even in women This suggests that female sex hormones may have a protective influence regarding GI cancer risk. According to recent cancer statistics, in South Korea, among women aged 65 years or older, the first and second most common cancers are colorectal and stomach cancer, respectively [2]. These statistics show GI cancer incidence in postmenopausal Korean women rising rapidly [2]
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