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Hormone Use, Reproductive History, and Risk of Lung Cancer: The Women's Health Initiative Studies
Ann G Schwartz1, Roberta M Ray, Michele L Cote
1*Karmanos Cancer Institute and Department of Oncology, Wayne State University, Detroit, Michigan; †Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle Washington; ‡C.S. Mott Center for Human Growth and Development and Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan; §St. Joseph Mercy Oakland Hospital, Pontiac, Michigan; ‖Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; ¶Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; #Department of Medicine, University of California, Irvine, California; **Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; ††Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, Florida; ‡‡Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; §§Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California; ‖‖Department of Epidemiology and Environmental Health, University of Buffalo School of Public Health and Health Professions, Buffalo, New York; and ¶¶Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford Cancer Institute, Stanford, California.
This study found that hormone therapy (HT) use under five years was associated with reduced lung cancer risk. However, evidence linking reproductive history to lung cancer risk remains weak, warranting further investigation.
Area of Science:
- Oncology
- Epidemiology
- Women's Health
Background:
- Previous Women's Health Initiative (WHI) trials showed no increased lung cancer risk with postmenopausal hormone therapy (HT).
- This study jointly analyzed WHI observational and clinical trial data to investigate estrogen's role in lung cancer risk.
Purpose of the Study:
- To explore the association between estrogen exposure, reproductive factors, and lung cancer risk in women.
- To further clarify the relationship between hormone therapy use and lung cancer incidence.
Main Methods:
- Analysis of reproductive history, oral contraceptive use, and HT exposure in 160,855 women.
- Longitudinal follow-up for lung cancer ascertainment, with 2467 incident cases over a median of 14 years.
Main Results:
- Estrogen plus progestin HT use for less than 5 years was linked to a reduced risk of lung cancer (HR=0.84, 95% CI=0.71-0.99).
- Trends showed decreased lung cancer risk with later age at menopause and increased risk with more live births.
- Reduced non-small-cell lung cancer risk was observed for first live birth between ages 20-29.
Conclusions:
- Indirect measures of estrogen exposure provide limited evidence for an association between reproductive history or HT use and lung cancer risk.
- Further mechanistic studies are needed, considering estrogen receptor expression in the lung, as estrogen's role cannot be excluded.
- Estrogen may hold potential for future lung cancer prevention and treatment strategies.
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