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The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study

BACKGROUND: The 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. METHODS: A prescription-based cohort study was conduct...

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Autores principales: Nam, Ji Hyung, Jang, Sung-In, Park, Hyun Soo, Kim, Jae Hak, Lee, Jun Kyu, Lim, Yun Jeong, Koh, Moon-Soo, Lee, Jin Ho, Park, Sohee, Nam, Chung Mo, Park, Eun-Cheol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609757/
https://www.ncbi.nlm.nih.gov/pubmed/34814853
http://dx.doi.org/10.1186/s12876-021-02021-y
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author Nam, Ji Hyung
Jang, Sung-In
Park, Hyun Soo
Kim, Jae Hak
Lee, Jun Kyu
Lim, Yun Jeong
Koh, Moon-Soo
Lee, Jin Ho
Park, Sohee
Nam, Chung Mo
Park, Eun-Cheol
author_facet Nam, Ji Hyung
Jang, Sung-In
Park, Hyun Soo
Kim, Jae Hak
Lee, Jun Kyu
Lim, Yun Jeong
Koh, Moon-Soo
Lee, Jin Ho
Park, Sohee
Nam, Chung Mo
Park, Eun-Cheol
author_sort Nam, Ji Hyung
collection PubMed
description BACKGROUND: The 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. METHODS: A 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. RESULTS: The 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 (P(trend) = 0.0002) and mortality (P(trend) = 0.0064). CONCLUSIONS: The 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-021-02021-y.
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spelling pubmed-86097572021-11-23 The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study Nam, Ji Hyung Jang, Sung-In Park, Hyun Soo Kim, Jae Hak Lee, Jun Kyu Lim, Yun Jeong Koh, Moon-Soo Lee, Jin Ho Park, Sohee Nam, Chung Mo Park, Eun-Cheol BMC Gastroenterol Research BACKGROUND: The 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. METHODS: A 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. RESULTS: The 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 (P(trend) = 0.0002) and mortality (P(trend) = 0.0064). CONCLUSIONS: The 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-021-02021-y. BioMed Central 2021-11-23 /pmc/articles/PMC8609757/ /pubmed/34814853 http://dx.doi.org/10.1186/s12876-021-02021-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Nam, Ji Hyung
Jang, Sung-In
Park, Hyun Soo
Kim, Jae Hak
Lee, Jun Kyu
Lim, Yun Jeong
Koh, Moon-Soo
Lee, Jin Ho
Park, Sohee
Nam, Chung Mo
Park, Eun-Cheol
The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_full The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_fullStr The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_full_unstemmed The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_short The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_sort effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in south korea: a population-based cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609757/
https://www.ncbi.nlm.nih.gov/pubmed/34814853
http://dx.doi.org/10.1186/s12876-021-02021-y
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