Hormone replacement therapy and colorectal adenoma recurrence among women in the polyp prevention trial

Karen Woodson, Elaine Lanza, Joseph A. Tangrea, Paul S. Albert, Martha Slattery, Joan Pinsky, Bette Caan, Electra Paskett, Frank Iber, J. Walter Kikendall, Michael P Lance, Moshe Shike, Joel Weissfeld, Arthur Schatzkin

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)1799-1805
Number of pages7
JournalJournal of the National Cancer Institute
Volume93
Issue number23
StatePublished - Dec 5 2001
Externally publishedYes

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Hormone Replacement Therapy
Polyps
Adenoma
Recurrence
Odds Ratio
Confidence Intervals
Estrogens
Hormones
Logistic Models
Adenomatous Polyps
Progestins
Risk Reduction Behavior
Colonoscopy
Alcohol Drinking
Epidemiologic Studies
Colorectal Neoplasms
Body Mass Index
Age Groups
Prospective Studies
Interviews

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Woodson, K., Lanza, E., Tangrea, J. A., Albert, P. S., Slattery, M., Pinsky, J., ... Schatzkin, A. (2001). Hormone replacement therapy and colorectal adenoma recurrence among women in the polyp prevention trial. Journal of the National Cancer Institute, 93(23), 1799-1805.

Hormone replacement therapy and colorectal adenoma recurrence among women in the polyp prevention trial. / Woodson, Karen; Lanza, Elaine; Tangrea, Joseph A.; Albert, Paul S.; Slattery, Martha; Pinsky, Joan; Caan, Bette; Paskett, Electra; Iber, Frank; Kikendall, J. Walter; Lance, Michael P; Shike, Moshe; Weissfeld, Joel; Schatzkin, Arthur.

In: Journal of the National Cancer Institute, Vol. 93, No. 23, 05.12.2001, p. 1799-1805.

Research output: Contribution to journalArticle

Woodson, K, Lanza, E, Tangrea, JA, Albert, PS, Slattery, M, Pinsky, J, Caan, B, Paskett, E, Iber, F, Kikendall, JW, Lance, MP, Shike, M, Weissfeld, J & Schatzkin, A 2001, 'Hormone replacement therapy and colorectal adenoma recurrence among women in the polyp prevention trial', Journal of the National Cancer Institute, vol. 93, no. 23, pp. 1799-1805.
Woodson K, Lanza E, Tangrea JA, Albert PS, Slattery M, Pinsky J et al. Hormone replacement therapy and colorectal adenoma recurrence among women in the polyp prevention trial. Journal of the National Cancer Institute. 2001 Dec 5;93(23):1799-1805.
Woodson, Karen ; Lanza, Elaine ; Tangrea, Joseph A. ; Albert, Paul S. ; Slattery, Martha ; Pinsky, Joan ; Caan, Bette ; Paskett, Electra ; Iber, Frank ; Kikendall, J. Walter ; Lance, Michael P ; Shike, Moshe ; Weissfeld, Joel ; Schatzkin, Arthur. / Hormone replacement therapy and colorectal adenoma recurrence among women in the polyp prevention trial. In: Journal of the National Cancer Institute. 2001 ; Vol. 93, No. 23. pp. 1799-1805.
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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.",
author = "Karen Woodson and Elaine Lanza and Tangrea, {Joseph A.} and Albert, {Paul S.} and Martha Slattery and Joan Pinsky and Bette Caan and Electra Paskett and Frank Iber and Kikendall, {J. Walter} and Lance, {Michael P} and Moshe Shike and Joel Weissfeld and Arthur Schatzkin",
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T1 - Hormone replacement therapy and colorectal adenoma recurrence among women in the polyp prevention trial

AU - Woodson, Karen

AU - Lanza, Elaine

AU - Tangrea, Joseph A.

AU - Albert, Paul S.

AU - Slattery, Martha

AU - Pinsky, Joan

AU - Caan, Bette

AU - Paskett, Electra

AU - Iber, Frank

AU - Kikendall, J. Walter

AU - Lance, Michael P

AU - Shike, Moshe

AU - Weissfeld, Joel

AU - Schatzkin, Arthur

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N2 - 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.

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