TABLE 2.
Hazard ratio (HR) and 95% confidence interval (CI) for health outcomes among postmenopausal users by vaginal estrogen (VE) use, 1982–2012
| Outcome | No VE | VE | |||||
|---|---|---|---|---|---|---|---|
| Cases | Person years |
Cases | Person years |
Age-adjusted model |
Multivariable adjusted model 1a |
Multivariable adjusted model 2b |
|
| Total MI | 1339 | 696454 | 20 | 17884 | 0.56 (0.36–0.87) | 0.71 (0.45–1.10) | 0.73 (0.47–1.13) |
| Stroke | 1188 | 699023 | 22 | 17972 | 0.71 (0.47–1.09) | 0.82 (0.54–1.25) | 0.85 (0.56–1.29) |
| PE/DVT | 524 | 648536 | 11 | 16502 | 0.88 (0.48–1.60) | 1.05 (0.58–1.92) | 1.06 (0.58–1.93) |
| All cancer types | 5444 | 670766 | 139 | 17534 | 0.97 (0.82–1.15) | 1.05 (0.89–1.25) | 1.05 (0.89–1.25) |
| Invasive breast cancer | 1570 | 510880 | 40 | 11826 | 1.06 (0.77–1.44) | 1.13 (0.82–1.55) | 1.07 (0.78–1.47) |
| Ovarian cancer c | 202 | 621565 | 6 | 15798 | 1.12 (0.50–2.54) | 1.17 (0.52–2.66) | 1.17 (0.52–2.65) |
| Endometrial cancer d | 344 | 540085 | 11 | 13166 | 1.30 (0.71–2.38) | 1.62 (0.88–2.97) | 1.62 (0.88–2.97) |
| Colorectal cancer | 649 | 711936 | 13 | 18199 | 0.73 (0.42–1.27) | 0.78 (0.45–1.35) | 0.77 (0.45–1.34) |
| Hip fracture | 1055 | 708827 | 23 | 18148 | 0.88 (0.58–1.33) | 0.88 (0.58–1.34) | 0.91 (0.60–1.38) |
MI, myocardial infarction; PE/DVT, pulmonary embolism/deep vein thrombosis; VE, vaginal estrogen
Model 1 was adjusted for age (y), calendar time, race, smoking status, alcohol intake, physical activity (MET-h/wk), BMI (kg/m2), age at menopause, hysterectomy (except for endometrial cancer), bilateral oophorectomy (except for ovarian cancer), and history of past systemic hormone therapy use (y/n). Cardiovascular outcomes were also adjusted for aspirin use (at least 1/day).
Model 2 was adjusted for variables in model 1 and parental history of cancer. Cardiovascular models were also adjusted for history of high blood pressure, hypercholesterolemia, history of diabetes, and parental history of early MI. Breast cancer models were also adjusted for height, parity, age at first birth, BMI at age 18, history of benign breast disease, and mammogram screening in the previous cycle.
Excluded women with bilateral oophorectomy.
Endometrial cancer results are only shown for women with an intact uterus