The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study

Abstract Background The effect of menopausal hormone therapy (MHT) on gastrointestinal (GI) cancers is controversial, and no research has been conducted in the East. This study investigates the association between MHT and GI cancer risks in South Korea. Methods A prescription-based cohort study was...

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Autores principales:	Ji Hyung Nam, Sung-In Jang, Hyun Soo Park, Jae Hak Kim, Jun Kyu Lee, Yun Jeong Lim, Moon-Soo Koh, Jin Ho Lee, Sohee Park, Chung Mo Nam, Eun-Cheol Park
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Menopausal hormone therapy Gastrointestinal cancer Cohort study Mortality Dose–response relationship Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/b1ed07e6a5254d3bb730230af51b9694
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spelling	oai:doaj.org-article:b1ed07e6a5254d3bb730230af51b96942021-11-28T12:15:05ZThe effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study10.1186/s12876-021-02021-y1471-230Xhttps://doaj.org/article/b1ed07e6a5254d3bb730230af51b96942021-11-01T00:00:00Zhttps://doi.org/10.1186/s12876-021-02021-yhttps://doaj.org/toc/1471-230XAbstract Background The effect of menopausal hormone therapy (MHT) on gastrointestinal (GI) cancers is controversial, and no research has been conducted in the East. This study investigates the association between MHT and GI cancer risks in South Korea. Methods A prescription-based cohort study was conducted using the NHIS Sample Cohort (2002–2013) of Korea. We used 1:5 propensity score matching, and 22,577 MHT users and 111,113 non-users were selected. Kaplan–Meier survival curves with log-rank tests were used. Cox proportional hazard models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Landmark analysis was used to determine dose–response relationship. Results The median follow-up was 79.6 of months. Kaplan–Meier survival curve showed less frequent GI cancer diagnoses in MHT users compared to non-users (0.13 vs. 0.16 per 100,000 person-years). Menopausal hormone therapy was associated with decreased incidence of GI cancer (HR = 0.809, 95%CI = 0.691–0.946) and colorectal cancer (CRC) (HR = 0.757, 95%CI = 0.577–0.995). Gastric cancer (GC) incidence showed marginal significance (HR = 0.787, 95%CI = 0.605–1.023). The mortality from GI cancer was lower in MHT users than in non-users (HR = 0.737, 95%CI = 0.547–0.993). The relationship between MHT and GI cancer was stronger with increasing MHT dose in terms of both incidence (P trend = 0.0002) and mortality (P trend = 0.0064). Conclusions The association between MHT use and reduced risks of GI cancers was attributed to CRC and GC and showed a dose–response relationship in a population-based cohort study.Ji Hyung NamSung-In JangHyun Soo ParkJae Hak KimJun Kyu LeeYun Jeong LimMoon-Soo KohJin Ho LeeSohee ParkChung Mo NamEun-Cheol ParkBMCarticleMenopausal hormone therapyGastrointestinal cancerCohort studyMortalityDose–response relationshipDiseases of the digestive system. GastroenterologyRC799-869ENBMC Gastroenterology, Vol 21, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Menopausal hormone therapy Gastrointestinal cancer Cohort study Mortality Dose–response relationship Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Menopausal hormone therapy Gastrointestinal cancer Cohort study Mortality Dose–response relationship Diseases of the digestive system. Gastroenterology RC799-869 Ji Hyung Nam Sung-In Jang Hyun Soo Park Jae Hak Kim Jun Kyu Lee Yun Jeong Lim Moon-Soo Koh Jin Ho Lee Sohee Park Chung Mo Nam Eun-Cheol Park The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
description	Abstract Background The effect of menopausal hormone therapy (MHT) on gastrointestinal (GI) cancers is controversial, and no research has been conducted in the East. This study investigates the association between MHT and GI cancer risks in South Korea. Methods A prescription-based cohort study was conducted using the NHIS Sample Cohort (2002–2013) of Korea. We used 1:5 propensity score matching, and 22,577 MHT users and 111,113 non-users were selected. Kaplan–Meier survival curves with log-rank tests were used. Cox proportional hazard models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Landmark analysis was used to determine dose–response relationship. Results The median follow-up was 79.6 of months. Kaplan–Meier survival curve showed less frequent GI cancer diagnoses in MHT users compared to non-users (0.13 vs. 0.16 per 100,000 person-years). Menopausal hormone therapy was associated with decreased incidence of GI cancer (HR = 0.809, 95%CI = 0.691–0.946) and colorectal cancer (CRC) (HR = 0.757, 95%CI = 0.577–0.995). Gastric cancer (GC) incidence showed marginal significance (HR = 0.787, 95%CI = 0.605–1.023). The mortality from GI cancer was lower in MHT users than in non-users (HR = 0.737, 95%CI = 0.547–0.993). The relationship between MHT and GI cancer was stronger with increasing MHT dose in terms of both incidence (P trend = 0.0002) and mortality (P trend = 0.0064). Conclusions The association between MHT use and reduced risks of GI cancers was attributed to CRC and GC and showed a dose–response relationship in a population-based cohort study.
format	article
author	Ji Hyung Nam Sung-In Jang Hyun Soo Park Jae Hak Kim Jun Kyu Lee Yun Jeong Lim Moon-Soo Koh Jin Ho Lee Sohee Park Chung Mo Nam Eun-Cheol Park
author_facet	Ji Hyung Nam Sung-In Jang Hyun Soo Park Jae Hak Kim Jun Kyu Lee Yun Jeong Lim Moon-Soo Koh Jin Ho Lee Sohee Park Chung Mo Nam Eun-Cheol Park
author_sort	Ji Hyung Nam
title	The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_short	The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_full	The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_fullStr	The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_full_unstemmed	The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study
title_sort	effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in south korea: a population-based cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b1ed07e6a5254d3bb730230af51b9694
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The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality in South Korea: a population-based cohort study

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