Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
J Womens Health (Larchmt). 2010 Feb;19(2):279-88. doi: 10.1089/jwh.2009.1434.
The association between hormone therapy (HT) use and lung cancer risk is inconsistent in epidemiological studies. This meta-analysis was conducted to examine the association between HT and lung cancer risk.
We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library in April 2008. All articles searched were independently reviewed and selected by two evaluators according to predetermined inclusion and exclusion criteria.
We included a total of 11 studies (8 case-control studies and 3 prospective cohort studies), involving a total of 220,599 participants. When all studies were pooled, the odds ratio (OR) of HT use for lung cancer risk was 0.87 (95% confidence interval (CI) 0.74-1.02). In subgroup meta-analyses, there was no association among cohort studies (relative risk (RR) 1.01; 95% CI 0.74-1.38), while there was a significant association between HT use and lung cancer risk among case-control studies (OR 0.81; 95% CI 0.68-0.97) based on a random-effects model. No significant association between HT use and lung cancer risk was observed in most of the subgroup meta-analyses by methodological quality of study, type of HT use, duration of HT use, and histology of lung cancer, while significant protective effects were observed among former and never smokers except for current smokers. However, cumulative meta-analyses based on year of publication showed a distinct trend toward a protective effect of HT use on lung cancer risk in the recent studies.
Overall, the findings of this meta-analysis do not support the hypothesis that there is a link between HT use and lung cancer risk. Our findings should be evaluated in further prospective cohort studies.
激素治疗（HT）的使用与肺癌风险之间的关联在流行病学研究中并不一致。本荟萃分析旨在研究 HT 与肺癌风险之间的关系。
我们于 2008 年 4 月检索了 MEDLINE（PubMed）、EMBASE 和 Cochrane 图书馆。所有检索到的文章均由两名评估人员根据预先确定的纳入和排除标准独立进行审查和选择。
我们共纳入了 11 项研究（8 项病例对照研究和 3 项前瞻性队列研究），共涉及 220599 名参与者。当所有研究合并时，HT 使用与肺癌风险的比值比（OR）为 0.87（95%置信区间（CI）为 0.74-1.02）。在亚组荟萃分析中，队列研究之间没有关联（相对风险（RR）为 1.01；95%CI 为 0.74-1.38），而病例对照研究中 HT 使用与肺癌风险之间存在显著关联（OR 为 0.81；95%CI 为 0.68-0.97）基于随机效应模型。根据研究方法学质量、HT 使用类型、HT 使用持续时间和肺癌组织学等大多数亚组荟萃分析，HT 使用与肺癌风险之间没有显著关联，但在以前和从不吸烟者中观察到了显著的保护作用，除了当前吸烟者。然而，基于出版物年份的累积荟萃分析显示，最近的研究中 HT 使用对肺癌风险的保护作用呈明显趋势。
总体而言，本荟萃分析的结果不支持 HT 使用与肺癌风险之间存在关联的假设。我们的发现应在进一步的前瞻性队列研究中进行评估。
