Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Department of Global Health Policy, Graduate School of Medicine, The University of 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Sci Rep. 2022 Jul 29;12(1):12997. doi: 10.1038/s41598-022-17345-2.
Hormone replacement therapy (HRT) is widely used to relieve menopausal symptoms; however, it remains unclear whether the use of HRT was associated with gastric cancer. We conducted a systematic review and meta-analysis to synthesize available evidence. This study followed the PRISMA guideline to report meta-analysis. PubMed, Embase, and Cochrane library were searched from conception through 23 February 2022. Eligible studies reporting risk of gastric cancer after HRT were screened and accessed by two independent reviewers. Random-effects meta-analysis was used to calculate pooled risk estimate as relative risk (RR, 95% CI). Pre-established review protocol was registered in PROSPERO (CRD42021281260). Among the 1095 articles identified, we included 11 studies with 1,919,089 women in this meta-analysis. The combined risk estimate (RR, 0.72; 95% CI 0.64-0.81; I = 2%) indicated that the use of HRT was associated with a 28% reduction in risk of gastric cancer compared with those who had no HRT exposure. The narrow prediction interval (0.62-0.84) for gastric cancer risk suggested a low between-study variance. In subgroup analysis defined by HRT formulation, there were reduction in risks of gastric cancer after the use of estrogen-only therapy (Pooled RR, 0.63; 95% CI 0.51-0.77, I = 0%) and estrogen-progestin therapy (Pooled RR, 0.70; 95% CI 0.57-0.87; I = 0%), as compared with non-users. In this systematic review and meta-analysis, the use of HRT was associated with a reduced gastric cancer risk regardless of HRT formulation. Further investigations are warranted to confirm underlying mechanisms.
激素替代疗法（HRT）被广泛用于缓解更年期症状；然而，HRT 的使用是否与胃癌相关仍不清楚。我们进行了系统评价和荟萃分析以综合现有证据。本研究遵循 PRISMA 指南报告荟萃分析。从概念到 2022 年 2 月 23 日，通过 PubMed、Embase 和 Cochrane 图书馆进行了搜索。由两名独立审查员筛选和获取报告 HRT 后胃癌风险的合格研究。使用随机效应荟萃分析计算汇总风险估计值作为相对风险（RR，95%CI）。预先制定的审查方案在 PROSPERO（CRD42021281260）中注册。在确定的 1095 篇文章中，我们纳入了 11 项研究，其中 1919089 名女性参与了荟萃分析。综合风险估计值（RR，0.72；95%CI 0.64-0.81；I=2%）表明，与未使用 HRT 暴露的女性相比，使用 HRT 与胃癌风险降低 28%相关。胃癌风险的狭窄预测区间（0.62-0.84）表明研究间差异较小。根据 HRT 制剂进行的亚组分析显示，雌激素单药治疗（汇总 RR，0.63；95%CI 0.51-0.77，I=0%）和雌激素孕激素治疗（汇总 RR，0.70；95%CI 0.57-0.87；I=0%）后胃癌风险降低。在这项系统评价和荟萃分析中，无论 HRT 制剂如何，使用 HRT 与降低胃癌风险相关。需要进一步的研究来证实潜在的机制。
