Menopausal hormone therapy: assessing associations with breast and colorectal cancers by familial risk

Menopausal users of hormone replacement therapy (HRT) are at increased breast cancer risk and decreased colorectal cancer (CRC) risk compared with individuals who have never used HRT, but these opposing associations may differ by familial risk of breast cancer and CRC. We harmonized data from 3 cohorts and generated separate breast cancer and CRC familial risk scores based on cancer family history. We defined moderate or strong family history as a risk score of 0.4 or higher, where 0.4 was equivalent to a 50-year-old woman with 1 parent diagnosed with either breast cancer or CRC at 55 years of age. Of 24 486 women assessed, 1243 and 405 were diagnosed with incident breast cancer and CRC, respectively. For breast cancer, menopausal HRT ever use versus never use hazard ratios were 1.27 (95% CI = 1.11 to 1.45) for a breast cancer familial risk score below 0.4 and 1.01 (95% CI = 0.82 to 1.25) for a breast cancer familial risk score of 0.4 or higher (Pdifference = .08). For CRC, menopausal HRT hazard ratios were 0.63 (95% CI = 0.50 to 0.78) for a CRC familial risk score below 0.4 and 1.21 (95% CI = 0.73 to 2.00) for a CRC familial risk score of 0.4 or higher (Pdifference = .03). Associations with menopausal HRT use that apply to the general population may not hold for women at moderate or strong familial risk of these cancers.

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Publication Details

Journal
JNCI Cancer Spectrum
Published
2024-12-03
DOI
https://doi.org/10.1093/jncics/pkae121
Primary Topic
Estrogen and related hormone effects
Type
article
Field-Weighted Citation Impact
0.00

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article

Menopausal hormone therapy: assessing associations with breast and colorectal cancers by familial risk

Steven Gallinger, Graham G. Giles, Amanda I. Phipps, John L. Hopper et al.
JNCI Cancer Spectrum
Estrogen and related hormone effects
article

Menopausal hormone therapy: assessing associations with breast and colorectal cancers by familial risk

Steven Gallinger, Graham G. Giles, Amanda I. Phipps, John L. Hopper, Kelly‐Anne Phillips, Roger Laughlin Milne, Polly A. Newcomb, Esther M. John, Loı̈c Le Marchand, Rish K. Pai, Sarah V. Colonna, Daniel D. Buchanan, N. Jewel Samadder, Mary Beth Terry, Finlay Macrae, Robert J. MacInnis, Mary B. Daly, Stephanie L. Schmit, Melissa C. Southey, Mark A. Jenkins, Irene L. Andrulis
article en

Abstract

Menopausal users of hormone replacement therapy (HRT) are at increased breast cancer risk and decreased colorectal cancer (CRC) risk compared with individuals who have never used HRT, but these opposing associations may differ by familial risk of breast cancer and CRC. We harmonized data from 3 cohorts and generated separate breast cancer and CRC familial risk scores based on cancer family history. We defined moderate or strong family history as a risk score of 0.4 or higher, where 0.4 was equivalent to a 50-year-old woman with 1 parent diagnosed with either breast cancer or CRC at 55 years of age. Of 24 486 women assessed, 1243 and 405 were diagnosed with incident breast cancer and CRC, respectively. For breast cancer, menopausal HRT ever use versus never use hazard ratios were 1.27 (95% CI = 1.11 to 1.45) for a breast cancer familial risk score below 0.4 and 1.01 (95% CI = 0.82 to 1.25) for a breast cancer familial risk score of 0.4 or higher (Pdifference = .08). For CRC, menopausal HRT hazard ratios were 0.63 (95% CI = 0.50 to 0.78) for a CRC familial risk score below 0.4 and 1.21 (95% CI = 0.73 to 2.00) for a CRC familial risk score of 0.4 or higher (Pdifference = .03). Associations with menopausal HRT use that apply to the general population may not hold for women at moderate or strong familial risk of these cancers.

JNCI Cancer SpectrumVol. 9(1)
Ontario Institute for Cancer Research (CA), Fox Chase Cancer Center (US), Cleveland Clinic (US), The Royal Melbourne Hospital (AU), University Health Network (CA), The University of Melbourne (AU), University of Toronto (CA), Cancer Council Victoria (AU), University of Washington (US), Lunenfeld-Tanenbaum Research Institute (CA), University of Utah (US), Columbia University Irving Medical Center (US), Peter MacCallum Cancer Centre (AU), Huntsman Cancer Institute (US), WinnMed (US), Fred Hutch Cancer Center (US), Cancer Center of Hawaii (US), Stanford Health Care (US), University Hospitals Seidman Cancer Center (US), Monash Health (AU), Mayo Clinic in Arizona (US), Mayo Clinic Hospital (US), Sinai Health System (CA), Stanford Medicine (US), University of Washington Applied Physics Laboratory (US), Mayo Clinic in Florida (US), Paediatric Integrated Cancer Service (AU), Case Comprehensive Cancer Center, Monash University (AU), Columbia University (US), Stanford University (US)
Breast Cancer Research Foundation, National Breast Cancer Foundation, Cancer Australia, National Institutes of Health, Medical Research Council, National Health and Medical Research Council, Cancer Council Victoria, National Cancer Institute
Good health and well-being
Openalex Percentile: Top 74%
Estrogen and related hormone effects
DOIOpen Access PDFOpenAlex
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