Grodstein F, Newcomb P A, Stampfer M J
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Am J Med. 1999 May;106(5):574-82. doi: 10.1016/s0002-9343(99)00063-7.
Colorectal cancer is the fourth most common cancer and the second leading cause of cancer death in the United States. Accumulating evidence indicates that postmenopausal hormone therapy may reduce the risk of colorectal cancer in women.
Through MEDLINE computer searches (January 1966 to September 1998) and a review of references, we identified English-language articles with quantitative data on the relation of postmenopausal hormone therapy to colorectal cancer. We reviewed the studies and made summary estimates of relative risks (RR) by weighting the results of each study in proportion to its precision, using a general variance-based, fixed-effects model.
In our meta-analysis of 18 epidemiologic studies of postmenopausal hormone therapy and colorectal cancer, we found a 20% reduction [RR = 0.80, 95% confidence interval (CI), 0.74 to 0.86] in risk of colon cancer and a 19% decrease (RR = 0.81, 95% CI, 0.72 to 0.92) in the risk of rectal cancer for postmenopausal women who had ever taken hormone therapy compared with women who never used hormones. Much of the apparent reduction in colorectal cancer was limited to current hormone users (RR = 0.66, 95% CI, 0.59 to 0.74).
Observational studies suggest a reduced risk of colorectal cancer among women taking postmenopausal hormones. There is biologic evidence to support this association.
结直肠癌是美国第四大常见癌症，也是癌症死亡的第二大主要原因。越来越多的证据表明，绝经后激素治疗可能会降低女性患结直肠癌的风险。
通过医学文献数据库（MEDLINE）计算机检索（1966年1月至1998年9月）并查阅参考文献，我们确定了有关绝经后激素治疗与结直肠癌关系的英文定量数据文章。我们对这些研究进行了综述，并使用基于方差的固定效应模型，根据每项研究结果的精确程度加权，对相对风险（RR）进行了汇总估计。
在我们对18项绝经后激素治疗与结直肠癌的流行病学研究的荟萃分析中，我们发现，与从未使用过激素的女性相比，曾经接受过激素治疗的绝经后女性患结肠癌的风险降低了20%[RR = 0.80，95%置信区间（CI），0.74至0.86]，患直肠癌的风险降低了19%（RR = 0.81，95%CI，0.72至0.92）。结直肠癌风险的明显降低大多局限于目前仍在使用激素的女性（RR = 0.66，95%CI，0.59至0.74）。
观察性研究表明，服用绝经后激素的女性患结直肠癌的风险降低。有生物学证据支持这一关联。
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