Table 4.
Type of menopausal hormone therapy with adenocarcinoma cancer risk.
| Variable | Cohort | Adenocarcinomas of the esophagus and stomach |
Esophageal adenocinarma + Gastric Cardia |
Non-cardia gastric cancer | |||
|---|---|---|---|---|---|---|---|
| No. (%) | No. (%) | HR* (95% CI) | No. (%) | HR* (95% CI) | No. (%) | HR* (95% CI) | |
| Among women with a hysterectomy | 51,515 (100) | 38 (100) | 19 (100) | 19 (100) | |||
| No MHT † | 10,522 (20.4) | 6 (15.8) | 1.00 (ref) | 3 (15.8) | 1.00 (ref) | 3 (15.8) | 1.00 (ref) |
| Ever used ET | 29,645 (57.6) | 23 (60.5) | 1.78 (0.71-4.44) | 11 (57.9) | 1.78 (0.48-6.56) | 12 (63.2) | 1.68 (0.46-6.10) |
| Recency | |||||||
| Former (% of ET users) | 6,275 (21.4) | 7 (30.4) | 2.25 (0.75-6.75) | 4 (36.4) | 2.59 (0.57-11.77) | 3 (25.0) | 1.80 (0.36-9.02) |
| Current (% of ET users) | 23,109 (78.6) | 16 (69.6) | 1.65 (0.63-4.31) | 7 (64.6) | 1.53 (0.38-6.13) | 9 (75.0) | 1.68 (0.44-6.38) |
| p trend = 0.392 | p trend = 0.662 | p trend = 0.484 | |||||
| Total duration of use | |||||||
| < 10 years (% of ET users) | 12,729 (43.6) | 11 (47.8) | 2.20 (0.80-6.05) | 5 (45.5) | 2.04 (0.48-8.74) | 6 (50.0) | 2.21 (0.54-9.06) |
| 10+ years (% of ET users) | 16,458 (56.4) | 12 (52.2) | 1.57 (0.58-4.27) | 6 (55.5) | 1.65 (0.40-6.83) | 6 (50.0) | 1.42 (0.35-5.83) |
| p trend = 0.479 | p trend = 0.548 | p trend = 0.739 | |||||
| Ever used EPT | 8,075 (15.7) | 6 (15.8) | 2.01 (0.63-6.44) | 4 (21.1) | 2.72 (0.57-12.87) | 2 (10.5) | 1.24 (0.20-7.70) |
| Ever used other or unknown type | 3242 (6.3) | 3 (7.9) | 1.92 (0.48-7.75) | 1 (5.3) | 1.35 (0.14-13.24) | 2 (10.5) | 2.12 (0.35-12.95) |
|
| |||||||
| Among women with an intact uterus | 74,372 (100) | 49 (100) | 19 (100) | 30 (100) | |||
| No MHT † | 38,404 (51.7) | 34 (69.4) | 1.00 (ref) | 11 (57.9) | 1.00 (ref) | 23 (76.7) | 1.00 (ref) |
| Ever used EPT | 28,060 (37.8) | 11 (22.5) | 0.52 (0.26-1.07) | 6 (31.6) | 0.73 (0.26-2.06) | 5 (16.7) | 0.40 (0.15-1.09) |
| Recency | |||||||
| Former (% of EPT users) | 6,291 (22.7) | 2 (18.2) | 0.41 (0.10-1.71) | 1 (16.7) | 0.54 (0.07-4.26) | 1 (20.0) | 0.34 (0.05-2.51) |
| Current (% of EPT users) | 21,376 (77.3) | 9 (81.8) | 0.57 (0.27-1.24) | 5 (83.3) | 0.81 (0.27-2.44) | 4 (80.0) | 0.43 (0.14-1.30) |
| p for trend = 0.122 | p trend = 0.669 | p trend = 0.105 | |||||
| Total duration of use | |||||||
| < 5 years (% of EPT users) | 12,277 (44.8) | 4 (40.0) | 0.51 (0.18-1.46) | 2 (40.0) | 0.61 (0.13-2.85) | 2 (40.0) | 0.46 (0.11-1.99) |
| 5+ years (% of EPT users) | 15,152 (55.2) | 6 (60.0) | 0.47 (0.19-1.16) | 3 (60.0) | 0.62 (0.17-2.31) | 3 (60.0) | 0.39 (0.11-1.34) |
| p for trend = 0.068 | p trend = 0.421 | p trend = 0.098 | |||||
| Regimen of use | |||||||
| Sequential (< 15 days/month) | 10,029 (38.6) | 3 (27.3) | 0.41 (0.12-1.36) | 1 (16.7) | 0.35 (0.04-2.81) | 2 (40.0) | 0.46 (0.10-2.00) |
| Continuous (15 + days/month) | 15,927 (61.4) | 8 (72.7) | 0.67 (0.30-1.49) | 5 (83.3) | 1.06 (0.35-3.15) | 3 (60.0) | 0.43 (0.13-1.48) |
| Ever used ET | 5,276 (7.1) | 3 (6.1) | 0.60 (0.18-1.96) | 2 (10.5) | 1.22 (0.27-5.52) | 1 (3.3) | 0.30 (0.04-2.22) |
| Ever used other or unknown type | 2,569 (3.5) | 1 (2.0) | 0.43 (0.06-3.18) | 0 (0) | -- | 1 (3.3) | 0.59 (0.08-4.42) |
*
Multivariate adjusted models, adjusted for age, body mass index, fruit and vegetable consumption, smoking use, alcohol intake, physical activity, and total energy intake.
†
Never users of menopausal hormone therapy (MHT) serve as the reference group for all categories. All models include indicator variables for use of estrogen therapy (ET), estrogen-plus-progestin (EPT), ever used other or unknown type of MHT, and missing data.