Dinger Jürgen C, Heinemann Lothar A J, Möhner Sabine, Thai Do Minh, Assmann Anita
Centre for Epidemiology & Health Research Berlin, Berlin, Germany.
BMC Cancer. 2007 May 8;7:76. doi: 10.1186/1471-2407-7-76.
Most studies have found no increased risk of colon cancer associated with hormone replacement therapy (HRT), or even a decreased risk. But information about the effects of different HRT preparations is lacking.
A case-control study was performed within Germany in collaboration with regional cancer registries and tumor centers. Up to 5 controls were matched to each case of colon cancer. Conditional logistic regression analysis was applied to estimate crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Stratified analyses were performed to get an impression of the risk associated with different estrogens and progestins.
A total of 354 cases of colon cancer were compared with 1422 matched controls. The adjusted overall risk estimate for colon cancer (ColC) associated with ever-use of HRT was 0.97 (0.71-1.32). No clinically relevant trends for ColC risk were observed with increasing duration of HRT use, or increasing time since first or last HRT use in aggregate. Whereas the overall risk estimates were stable, the numbers in many of the sub-analyses of HRT preparation groups (estrogens and progestins) were too small for conclusions. Nevertheless, if the ColC risk estimates are taken at face value, most seemed to be reduced compared with never-use of HRT, but did not vary much across HRT formulation subgroups. In particular, no substantial difference in ColC risk was observed between HRT-containing conjugated equine estrogens (CEE) or medroxyprogesterone acetate (MPA) and other formulations more common in Europe.
Ever-use of HRT was not associated with an increased risk of colon cancer. In contrary, most risk estimates pointed non-significantly toward a lower ColC risk in HRT ever user. They did not vary markedly among different HRT formulations (estrogens, progestins). However, the small numbers and the overlapping nature of the subgroups suggest cautious interpretation.
大多数研究发现，激素替代疗法（HRT）与结肠癌风险增加无关，甚至风险降低。但缺乏不同HRT制剂效果的相关信息。
在德国与地区癌症登记处和肿瘤中心合作开展了一项病例对照研究。每例结肠癌病例匹配多达5名对照。应用条件逻辑回归分析来估计粗比值比和调整后的比值比（OR）以及95%置信区间（95%CI）。进行分层分析以了解与不同雌激素和孕激素相关的风险情况。
共将354例结肠癌病例与1422名匹配对照进行了比较。与曾经使用HRT相关的结肠癌（ColC）调整后总体风险估计值为0.97（0.71 - 1.32）。未观察到随着HRT使用时间延长，或首次或最后一次HRT使用以来的总时间增加，ColC风险出现临床相关趋势。尽管总体风险估计值稳定，但HRT制剂组（雌激素和孕激素）的许多亚分析中的样本量过小，无法得出结论。然而，如果仅从表面价值看待ColC风险估计值，与从未使用HRT相比，大多数似乎有所降低，但在HRT制剂亚组之间变化不大。特别是，含结合马雌激素（CEE）或醋酸甲羟孕酮（MPA）的HRT与欧洲更常见的其他制剂之间，在ColC风险上未观察到实质性差异。
曾经使用HRT与结肠癌风险增加无关。相反，大多数风险估计值无显著差异地表明，曾经使用HRT者的ColC风险较低。不同HRT制剂（雌激素、孕激素）之间风险变化不明显。然而，亚组样本量小以及亚组的重叠性质提示解释时需谨慎。
