Unopposed estrogen and estrogen plus progestin menopausal hormone therapy and lung cancer risk in the NIH–AARP Diet and Health Study Cohort
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Previous studies have reported that lung cancer risk may be decreased, increased, or unaffected by prior use of menopausal hormone therapy (MHT).
To assess this issue further, we examined relationships among 118,008 women, ages 50–71 years who were recruited during 1995–1996 for the NIH–AARP Diet and Health Study and in whom 2,097 incident lung carcinomas were identified during follow-up through 2006. Multivariable Cox proportional hazards models estimated relative risks (RR) and 95% confidence intervals (CIs) associated with various measures of self-reported MHT use.
We found no evidence that either estrogen therapy (ET)-only or estrogen plus progestin therapy (EPT) use was substantially related to subsequent lung cancer risk (respective RRs and 95% CIs for ever use = 0.97, 0.86–1.09 and 1.03, 0.90–1.17). There were no significant variations according to currency or duration of use of either formulation, nor was there evidence that risks varied within subgroups defined by cigarette smoking or body size. The absence of effect was seen for nearly all lung cancer subtypes, with the exception of an increased risk of undifferentiated/large cell cancers associated with long-term ET-only use (p trend = 0.02), a relationship not observed among EPT users.
Our results failed to support any substantial alterations in lung cancer risk associated with use of either unopposed estrogen or estrogen plus progestin MHT, even when detailed exposure measures and other risk predictors were considered.
KeywordsLung cancer Menopausal hormone therapy Risk Histology
National Cancer Institute
American Association of Retired Persons
Menopausal hormone therapy
Estrogen plus progestin therapy
Non-small cell lung cancer
Not otherwise specified
Body mass index
This investigation was supported by the Intramural Research Program of the NIH.
- 13.Chlebowski RT, Anderson GL, Manson JE, Schwartz AG, Wakelee H, Gass M, Rodabough RJ, Johnson KC, Wactawski-Wende J, Kotchen JM, Ockene JK, O’Sullivan MJ et al (2010) Lung cancer among postmenopausal women treated with estrogen alone in the Women’s Health Initiative randomized trial. J Natl Cancer Inst 102(18):1413–1421PubMedCrossRefGoogle Scholar
- 15.Chlebowski RT, Schwartz AG, Wakelee H, Anderson GL, Stefanick ML, Manson JE, Rodabough RJ, Chien JW, Wactawski-Wende J, Gass M, Kotchen JM, Johnson KC et al (2009) Oestrogen plus progestin and lung cancer in postmenopausal women (Women’s Health Initiative trial): a post hoc analysis of a randomised controlled trial. Lancet 374(9697):1243–1251PubMedCrossRefGoogle Scholar
- 21.Schatzkin A, Subar AF, Thompson FE, Harlan LC, Tangrea J, Hollenbeck AR, Hurwitz PE, Coyle L, Schussler N, Michaud DS, Freedman LS, Brown CC et al (2001) Design and serendipity in establishing a large cohort with wide dietary intake distributions: the National Institutes of Health-American Association of Retired Persons Diet and Health Study. Am J Epidemiol 154(12):1119–1125PubMedCrossRefGoogle Scholar
- 22.Michaud DS, Micthune D, Hermansen S et al (2005) Comparison of cancer registry case ascertainment with SEER estimates and self-reporting in a subset of the NIH-AARP Diet and Health Study. J Regist Manag 32:70–75Google Scholar
- 23.Fritz A, Percy C, Jack A, et al. (2000) International classification of diseases for oncology, 3 Geneva, SwitzerlandGoogle Scholar
- 26.Clague J, Reynolds P, Sullivan-Halley J, Ma H, Lacey JV Jr, Henderson KD, Ursin G, West DW, Chang S, Delclos G, Du XL, Forman MR, et al. (2011) Menopausal hormone therapy does not influence lung cancer risk: results from the California Teachers Study. Cancer Epidemiol Biomarkers Prev 20(3):560–564Google Scholar
- 29.Smith L, Brinton LA, Spitz MR, Lam TK, Park Y, Hollenbeck AR, Freedman ND, Gierach GL (2011) Body mass index and lung cancer risk among never, former, and current smokers. J Natl Cancer Inst (in press)Google Scholar
- 32.Key TJ, Appleby PN, Reeves GK, Roddam AW, Helzlsouer KJ, Alberg AJ, Rollison DE, Dorgan JF, Brinton LA, Overvad K, Kaaks R, Trichopoulou A et al (2011) Circulating sex hormones and breast cancer risk factors in postmenopausal women: reanalysis of 13 studies. Br J Cancer 105(5):709–722PubMedCrossRefGoogle Scholar