Hormone therapy and esophageal adenocarcinoma

Drs. Xie and colleagues observed a decreased risk of esophageal adenocarcinoma among women taking post-menopausal hormones in this population-based cohort study in Sweden with 693 EAC cases. This supports the concept that female sex hormones contribute to the lower incidence of EAC in women.

British Journal of Cancer; https://doi.org/10.1038/s41416-021-01575-8

Menopausal hormone therapy and risk of oesophageal adenocarcinoma in a population-based cohort study

Shao-Hua Xie, Giola Santoni, and Jesper Lagergren

Abstract

BACKGROUND: Oesophageal adenocarcinoma is characterised by a strong male predominance. We aimed to test the hypothesis that menopausal hormonal therapy decreases the risk of oesophageal adenocarcinoma.

METHODS: This population-based cohort study included all women who used systemic menopausal hormonal therapy (exposed) in Sweden between 2005 and 2018. For each exposed participant, five randomly selected female age-matched non-users of menopausal hormonal therapy (unexposed) were included. Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, smoking-related diagnoses, Helicobacter pylori eradication, use of non-steroidal anti-inflammatory drugs/aspirin, use of statins and hysterectomy.

RESULTS: The study included 296,964 users of menopausal hormonal therapy and 1,484,820 non-users. Ever-users of menopausal hormonal therapy had an overall decreased risk of oesophageal adenocarcinoma (HR 0.78, 95% CI 0.63–0.97), which remained unchanged after further adjustment for gastro-oesophageal reflux disease (HR 0.78, 95% CI 0.63–0.97) and obesity/diabetes (HR 0.79, 95% CI 0.63–0.98). Decreased HRs were indicated both in users of oestrogen only (HR 0.82, 95% CI 0.60–1.12) and oestrogen combined with progestogen (HR 0.75, 95% CI 0.56–1.00). The risk reduction was more pronounced in users younger than 60 years (HR 0.57, 95% CI 0.38–0.86).

CONCLUSIONS: Menopausal hormone therapy in women may decrease the risk of oesophageal adenocarcinoma.

© The Author(s), under exclusive licence to Springer Nature Limited 2021

About
This website contains a curated and opinionated look at recent literature regarding the epidemiology and prevention of esophageal cancer, with an emphasis on esophageal adenocarcinoma. It is developed by Thomas L Vaughan MD, MPH ©2021
Disclaimer
This website should not be considered, or used as a substitute for, medical advice, diagnosis or treatment. This site does not constitute the practice of any medical or other professional health care advice, diagnosis or treatment. The information on this website represent the views solely of Dr. Vaughan.
Privacy
Cookies are used solely to quantify website use for resource planning. Complete IP addresses are not collected (i.e., 203.0.113.123 will be recorded as 203.0.113.??) Feel free to opt out of cookies using add-ins of your choice without affecting website function. No user information is collected by the risk calculator (IC-RISC).