Portland Veterans Affairs Medical Center; Division of Pulmonary and Critical Care Medicine, Oregon Health & Sciences University, Portland, OR; Clinical Research Division and Cancer Prevention Program, Fred Hutchison Cancer Research Center; Division of Pulmonary and Critical Care and Department of Epidemiology, University of Washington; Veterans Affairs Puget Sound Health Care System, Health Services Research and Development, Seattle, WA; and Departments of Nutrition and Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
J Clin Oncol. 2010 Feb 16.
Lung cancer is the leading cause of cancer−related mortality among women. The role of hormone replacement therapy (HRT) in lung cancer development is unclear.
We evaluated a prospective cohort of 36,588 peri− and postmenopausal women aged 50 to 76 years from Washington State recruited in 2000 to 2002 (Vitamins and Lifestyle [VITAL] Study). Lung cancer cases (n = 344) were identified through the Seattle−Puget Sound Surveillance, Epidemiology, and End Results cancer registry during 6 years of follow−up. Hazard ratios (HRs) associated with use and duration of specific HRT formulations were calculated for total incident lung cancer, specific morphologies, and cancer by stage at diagnosis.
After adjusting for smoking, age, and other potential confounders, there was an increased risk of incident lung cancer associated with increasing duration of estrogen plus progestin (E+P) use (HR = 1.27 for E+P use 1 to 9 years, 95% CI, 0.91 to 1.78; and HR = 1.48 for E+P use >/= 10 years, 95% CI, 1.03 to 2.12; P for trend = .03). There was no association with duration of unopposed estrogen use. Duration of E+P use was associated with an advanced stage at diagnosis (P for trend = .03).
Use of E+P increased the risk of incident lung cancer in a duration−dependent manner, with an approximate 50% increased risk for use of 10 years or longer. These findings may be helpful for informing women of their risk of developing lung cancer and delineating important pathways involved in hormone metabolism and lung cancer.
PMID: 20159813 [PubMed − as supplied by publisher] Source: National Library of Medicine.
