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Hormone Replacement Therapy and Colorectal Adenoma Recurrence Among Women in the Polyp Prevention Trial

Background: Epidemiologic studies have suggested that estrogen may protect against the development of colorectal cancers and adenomatous polyps. We conducted a prospective study to evaluate the association between hormone replacement therapy (HRT) and adenoma recurrence among perimenopausal and post...

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Published in:JNCI : Journal of the National Cancer Institute 2001-12, Vol.93 (23), p.1799-1805
Main Authors: Woodson, Karen, Lanza, Elaine, Tangrea, Joseph A., Albert, Paul S., Slattery, Martha, Pinsky, Joan, Caan, Bette, Paskett, Electra, Iber, Frank, Kikendall, J. Walter, Lance, Peter, Shike, Moshe, Weissfeld, Joel, Schatzkin, Arthur
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container_title JNCI : Journal of the National Cancer Institute
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creator Woodson, Karen
Lanza, Elaine
Tangrea, Joseph A.
Albert, Paul S.
Slattery, Martha
Pinsky, Joan
Caan, Bette
Paskett, Electra
Iber, Frank
Kikendall, J. Walter
Lance, Peter
Shike, Moshe
Weissfeld, Joel
Schatzkin, Arthur
description Background: Epidemiologic studies have suggested that estrogen may protect against the development of colorectal cancers and adenomatous polyps. We conducted a prospective study to evaluate the association between hormone replacement therapy (HRT) and adenoma recurrence among perimenopausal and postmenopausal women participating in the Polyp Prevention Trial, a randomized dietary intervention study of individuals with colorectal adenomas. Methods: We used a questionnaire and interviews to collect detailed information, at baseline and at each of four annual study visits, from 620 women regarding hormone use, menopausal status, diet, alcohol consumption, and other risk factors. Adenoma recurrence was ascertained by complete colonoscopy at baseline and after 1 and 4 years. Logistic regression models were used to evaluate the association between hormone use and adenoma recurrence after adjusting for intervention group and for age and body mass index at baseline. All statistical tests were two-sided. Results: Adenomas recurred in 200 women. There was no overall association between adenoma recurrence and either overall hormone use (odds ratio [OR] = 1.01; 95% confidence interval [CI] = 0.70 to 1.45), combined estrogen and progestin use (OR = 0.94; 95% CI = 0.57 to 1.56), or unopposed estrogen use (OR = 1.04; 95% CI = 0.68 to 1.59). HRT use was associated with a reduction in risk for recurrence of distal adenomas (OR = 0.56; 95% CI = 0.32 to 1.00) and a statistically nonsignificant increase in risk for recurrence of proximal adenomas (OR = 1.39; 95% CI = 0.85 to 2.26). We observed a statistically significant interaction between the HRT–adenoma recurrence association and age (P = .02). HRT was associated with a 40% reduced risk of adenoma recurrence among women older than 62 years (OR = 0.58; 95% CI = 0.35 to 0.97) but with an increased risk among women younger than 62 years (OR = 1.99; 95% CI = 1.11 to 3.55). Conclusions: HRT was not associated with a reduced risk for overall adenoma recurrence in this trial cohort, although there was a suggestion of an age interaction. The effect of age on the association needs to be confirmed in other adenoma recurrence trials.
doi_str_mv 10.1093/jnci/93.23.1799
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Walter ; Lance, Peter ; Shike, Moshe ; Weissfeld, Joel ; Schatzkin, Arthur</creator><creatorcontrib>Woodson, Karen ; Lanza, Elaine ; Tangrea, Joseph A. ; Albert, Paul S. ; Slattery, Martha ; Pinsky, Joan ; Caan, Bette ; Paskett, Electra ; Iber, Frank ; Kikendall, J. Walter ; Lance, Peter ; Shike, Moshe ; Weissfeld, Joel ; Schatzkin, Arthur</creatorcontrib><description>Background: Epidemiologic studies have suggested that estrogen may protect against the development of colorectal cancers and adenomatous polyps. We conducted a prospective study to evaluate the association between hormone replacement therapy (HRT) and adenoma recurrence among perimenopausal and postmenopausal women participating in the Polyp Prevention Trial, a randomized dietary intervention study of individuals with colorectal adenomas. Methods: We used a questionnaire and interviews to collect detailed information, at baseline and at each of four annual study visits, from 620 women regarding hormone use, menopausal status, diet, alcohol consumption, and other risk factors. Adenoma recurrence was ascertained by complete colonoscopy at baseline and after 1 and 4 years. Logistic regression models were used to evaluate the association between hormone use and adenoma recurrence after adjusting for intervention group and for age and body mass index at baseline. All statistical tests were two-sided. Results: Adenomas recurred in 200 women. There was no overall association between adenoma recurrence and either overall hormone use (odds ratio [OR] = 1.01; 95% confidence interval [CI] = 0.70 to 1.45), combined estrogen and progestin use (OR = 0.94; 95% CI = 0.57 to 1.56), or unopposed estrogen use (OR = 1.04; 95% CI = 0.68 to 1.59). HRT use was associated with a reduction in risk for recurrence of distal adenomas (OR = 0.56; 95% CI = 0.32 to 1.00) and a statistically nonsignificant increase in risk for recurrence of proximal adenomas (OR = 1.39; 95% CI = 0.85 to 2.26). We observed a statistically significant interaction between the HRT–adenoma recurrence association and age (P = .02). HRT was associated with a 40% reduced risk of adenoma recurrence among women older than 62 years (OR = 0.58; 95% CI = 0.35 to 0.97) but with an increased risk among women younger than 62 years (OR = 1.99; 95% CI = 1.11 to 3.55). Conclusions: HRT was not associated with a reduced risk for overall adenoma recurrence in this trial cohort, although there was a suggestion of an age interaction. The effect of age on the association needs to be confirmed in other adenoma recurrence trials.</description><identifier>ISSN: 0027-8874</identifier><identifier>EISSN: 1460-2105</identifier><identifier>DOI: 10.1093/jnci/93.23.1799</identifier><identifier>PMID: 11734596</identifier><identifier>CODEN: JNCIEQ</identifier><language>eng</language><publisher>Cary, NC: Oxford University Press</publisher><subject>Adenoma - drug therapy ; Adenoma - pathology ; Adenoma - prevention &amp; control ; Adult ; Age Factors ; Aged ; Biological and medical sciences ; Colonoscopy ; Colorectal Neoplasms - drug therapy ; Colorectal Neoplasms - pathology ; Colorectal Neoplasms - prevention &amp; control ; Estrogens - therapeutic use ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Hormone Replacement Therapy ; Humans ; Medical sciences ; Menopause ; Middle Aged ; Odds Ratio ; Postmenopause ; Progestins - therapeutic use ; Recurrence ; Regression Analysis ; Risk Factors ; Stomach. Duodenum. 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Walter</creatorcontrib><creatorcontrib>Lance, Peter</creatorcontrib><creatorcontrib>Shike, Moshe</creatorcontrib><creatorcontrib>Weissfeld, Joel</creatorcontrib><creatorcontrib>Schatzkin, Arthur</creatorcontrib><title>Hormone Replacement Therapy and Colorectal Adenoma Recurrence Among Women in the Polyp Prevention Trial</title><title>JNCI : Journal of the National Cancer Institute</title><addtitle>JNCI J Natl Cancer Inst</addtitle><description>Background: Epidemiologic studies have suggested that estrogen may protect against the development of colorectal cancers and adenomatous polyps. We conducted a prospective study to evaluate the association between hormone replacement therapy (HRT) and adenoma recurrence among perimenopausal and postmenopausal women participating in the Polyp Prevention Trial, a randomized dietary intervention study of individuals with colorectal adenomas. Methods: We used a questionnaire and interviews to collect detailed information, at baseline and at each of four annual study visits, from 620 women regarding hormone use, menopausal status, diet, alcohol consumption, and other risk factors. Adenoma recurrence was ascertained by complete colonoscopy at baseline and after 1 and 4 years. Logistic regression models were used to evaluate the association between hormone use and adenoma recurrence after adjusting for intervention group and for age and body mass index at baseline. All statistical tests were two-sided. Results: Adenomas recurred in 200 women. There was no overall association between adenoma recurrence and either overall hormone use (odds ratio [OR] = 1.01; 95% confidence interval [CI] = 0.70 to 1.45), combined estrogen and progestin use (OR = 0.94; 95% CI = 0.57 to 1.56), or unopposed estrogen use (OR = 1.04; 95% CI = 0.68 to 1.59). HRT use was associated with a reduction in risk for recurrence of distal adenomas (OR = 0.56; 95% CI = 0.32 to 1.00) and a statistically nonsignificant increase in risk for recurrence of proximal adenomas (OR = 1.39; 95% CI = 0.85 to 2.26). We observed a statistically significant interaction between the HRT–adenoma recurrence association and age (P = .02). HRT was associated with a 40% reduced risk of adenoma recurrence among women older than 62 years (OR = 0.58; 95% CI = 0.35 to 0.97) but with an increased risk among women younger than 62 years (OR = 1.99; 95% CI = 1.11 to 3.55). Conclusions: HRT was not associated with a reduced risk for overall adenoma recurrence in this trial cohort, although there was a suggestion of an age interaction. 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Abdomen</topic><topic>Hormone Replacement Therapy</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Menopause</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Postmenopause</topic><topic>Progestins - therapeutic use</topic><topic>Recurrence</topic><topic>Regression Analysis</topic><topic>Risk Factors</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Time Factors</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Woodson, Karen</creatorcontrib><creatorcontrib>Lanza, Elaine</creatorcontrib><creatorcontrib>Tangrea, Joseph A.</creatorcontrib><creatorcontrib>Albert, Paul S.</creatorcontrib><creatorcontrib>Slattery, Martha</creatorcontrib><creatorcontrib>Pinsky, Joan</creatorcontrib><creatorcontrib>Caan, Bette</creatorcontrib><creatorcontrib>Paskett, Electra</creatorcontrib><creatorcontrib>Iber, Frank</creatorcontrib><creatorcontrib>Kikendall, J. Walter</creatorcontrib><creatorcontrib>Lance, Peter</creatorcontrib><creatorcontrib>Shike, Moshe</creatorcontrib><creatorcontrib>Weissfeld, Joel</creatorcontrib><creatorcontrib>Schatzkin, Arthur</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>JNCI : Journal of the National Cancer Institute</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Woodson, Karen</au><au>Lanza, Elaine</au><au>Tangrea, Joseph A.</au><au>Albert, Paul S.</au><au>Slattery, Martha</au><au>Pinsky, Joan</au><au>Caan, Bette</au><au>Paskett, Electra</au><au>Iber, Frank</au><au>Kikendall, J. Walter</au><au>Lance, Peter</au><au>Shike, Moshe</au><au>Weissfeld, Joel</au><au>Schatzkin, Arthur</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hormone Replacement Therapy and Colorectal Adenoma Recurrence Among Women in the Polyp Prevention Trial</atitle><jtitle>JNCI : Journal of the National Cancer Institute</jtitle><addtitle>JNCI J Natl Cancer Inst</addtitle><date>2001-12-05</date><risdate>2001</risdate><volume>93</volume><issue>23</issue><spage>1799</spage><epage>1805</epage><pages>1799-1805</pages><issn>0027-8874</issn><eissn>1460-2105</eissn><coden>JNCIEQ</coden><abstract>Background: Epidemiologic studies have suggested that estrogen may protect against the development of colorectal cancers and adenomatous polyps. We conducted a prospective study to evaluate the association between hormone replacement therapy (HRT) and adenoma recurrence among perimenopausal and postmenopausal women participating in the Polyp Prevention Trial, a randomized dietary intervention study of individuals with colorectal adenomas. Methods: We used a questionnaire and interviews to collect detailed information, at baseline and at each of four annual study visits, from 620 women regarding hormone use, menopausal status, diet, alcohol consumption, and other risk factors. Adenoma recurrence was ascertained by complete colonoscopy at baseline and after 1 and 4 years. Logistic regression models were used to evaluate the association between hormone use and adenoma recurrence after adjusting for intervention group and for age and body mass index at baseline. All statistical tests were two-sided. Results: Adenomas recurred in 200 women. There was no overall association between adenoma recurrence and either overall hormone use (odds ratio [OR] = 1.01; 95% confidence interval [CI] = 0.70 to 1.45), combined estrogen and progestin use (OR = 0.94; 95% CI = 0.57 to 1.56), or unopposed estrogen use (OR = 1.04; 95% CI = 0.68 to 1.59). HRT use was associated with a reduction in risk for recurrence of distal adenomas (OR = 0.56; 95% CI = 0.32 to 1.00) and a statistically nonsignificant increase in risk for recurrence of proximal adenomas (OR = 1.39; 95% CI = 0.85 to 2.26). We observed a statistically significant interaction between the HRT–adenoma recurrence association and age (P = .02). HRT was associated with a 40% reduced risk of adenoma recurrence among women older than 62 years (OR = 0.58; 95% CI = 0.35 to 0.97) but with an increased risk among women younger than 62 years (OR = 1.99; 95% CI = 1.11 to 3.55). Conclusions: HRT was not associated with a reduced risk for overall adenoma recurrence in this trial cohort, although there was a suggestion of an age interaction. The effect of age on the association needs to be confirmed in other adenoma recurrence trials.</abstract><cop>Cary, NC</cop><pub>Oxford University Press</pub><pmid>11734596</pmid><doi>10.1093/jnci/93.23.1799</doi><tpages>7</tpages></addata></record>
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subjects Adenoma - drug therapy
Adenoma - pathology
Adenoma - prevention & control
Adult
Age Factors
Aged
Biological and medical sciences
Colonoscopy
Colorectal Neoplasms - drug therapy
Colorectal Neoplasms - pathology
Colorectal Neoplasms - prevention & control
Estrogens - therapeutic use
Female
Gastroenterology. Liver. Pancreas. Abdomen
Hormone Replacement Therapy
Humans
Medical sciences
Menopause
Middle Aged
Odds Ratio
Postmenopause
Progestins - therapeutic use
Recurrence
Regression Analysis
Risk Factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Time Factors
Tumors
title Hormone Replacement Therapy and Colorectal Adenoma Recurrence Among Women in the Polyp Prevention Trial
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