Clague Jessica, Reynolds Peggy, Henderson Katherine D, Sullivan-Halley Jane, Ma Huiyan, Lacey James V, Chang Shine, Delclos George L, Du Xianglin L, Forman Michele R, Bernstein Leslie
Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, California, United States of America.
Cancer Prevention Institute of California, Fremont, California, United States of America.
PLoS One. 2014 Jul 31;9(7):e103735. doi: 10.1371/journal.pone.0103735. eCollection 2014.
Previous results from research on menopausal hormone therapy (MHT) and lung cancer survival have been mixed and most have not studied women who used estrogen therapy (ET) exclusively. We examined the associations between MHT use reported at baseline and lung cancer-specific mortality in the prospective California Teachers Study cohort. Among 727 postmenopausal women diagnosed with lung cancer from 1995 through 2007, 441 women died before January 1, 2008. Hazard Ratios (HR) and 95% Confidence Intervals (CI) for lung-cancer-specific mortality were obtained by fitting multivariable Cox proportional hazards regression models using age in days as the timescale. Among women who used ET exclusively, decreases in lung cancer mortality were observed (HR, 0.69; 95% CI, 0.52-0.93). No association was observed for estrogen plus progestin therapy use. Among former users, shorter duration (<5 years) of exclusive ET use was associated with a decreased risk of lung cancer mortality (HR, 0.56; 95% CI, 0.35-0.89), whereas among recent users, longer duration (>15 years) was associated with a decreased risk (HR, 0.60; 95% CI, 0.38-0.95). Smoking status modified the associations with deceases in lung cancer mortality observed only among current smokers. Exclusive ET use was associated with decreased lung cancer mortality.
先前关于绝经激素治疗(MHT)与肺癌生存率的研究结果不一,并且大多数研究未涉及仅使用雌激素治疗(ET)的女性。我们在加利福尼亚教师前瞻性队列研究中,考察了基线时报告的MHT使用情况与肺癌特异性死亡率之间的关联。在1995年至2007年期间被诊断为肺癌的727名绝经后女性中,有441名女性在2008年1月1日前死亡。通过使用以天数为时间尺度的多变量Cox比例风险回归模型,得出肺癌特异性死亡率的风险比(HR)和95%置信区间(CI)。在仅使用ET的女性中,观察到肺癌死亡率有所下降(HR,0.69;95%CI,0.52 - 0.93)。对于使用雌激素加孕激素治疗的情况,未观察到关联。在既往使用者中,仅使用ET的较短疗程(<5年)与肺癌死亡率风险降低相关(HR,0.56;95%CI,0.35 - 0.89),而在近期使用者中,较长疗程(>15年)与风险降低相关(HR,0.60;95%CI,0.38 - 0.95)。吸烟状况改变了仅在当前吸烟者中观察到的与肺癌死亡率下降的关联。仅使用ET与肺癌死亡率降低相关。