Open AccessIs hormone replacement therapy in post‐menopausal women associated with a reduced risk of oesophageal cancer?
Author(s) -
Me Shyam,
Nightingale Peter,
Trudgill Nigel
Publication year - 2014
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640614543736
Subject(s) - medicine , hormone replacement therapy (female to male) , hazard ratio , reflux , proportional hazards model , incidence (geometry) , cohort , cancer , gastroenterology , cohort study , gynecology , confidence interval , disease , physics , optics , testosterone (patch)
Purpose The rise in oesophageal adenocarcinoma incidence in women with age is delayed compared with men until the post‐menopausal period. A matched cohort study was therefore undertaken of post‐menopausal women on hormone replacement therapy (HRT) to examine the association between HRT, oesophageal cancer and the potentially associated conditions, reflux oesophagitis and Barrett's oesophagus. Methods Women aged over 50 years within the UK General Practice Research Database with a history of HRT exposure were matched by age and general practice with controls without HRT exposure (1:1). Matched Cox‐regression analysis was performed to estimate adjusted hazard ratios. Results 51,851 HRT users and controls were studied. Prolonged HRT use for 5–10 years (hazard ratio 0.25 (95% CI 0.07–0.95)) and time‐dependent covariates for increasing duration of HRT use (0.06 (0.01–0.43)) were associated with a reduced oesophageal cancer risk. HRT use was associated with reflux oesophagitis (1.27 (1.12–1.43)), but when analysis was confined to women with codes for both reflux oesophagitis and endoscopy there was no association (1.1 (0.81–1.44)), suggesting increased reporting of reflux symptoms among HRT users rather than an association with endoscopic reflux oesophagitis. Conclusion Long‐term post‐menopausal HRT may be associated with a reduced risk of oesophageal cancer.