Hormone replacement therapy and the risk of colorectal cancer: a meta-analysis

1999 ◽  
Vol 93 (5) ◽  
pp. 880-888 ◽  
Author(s):  
K NANDA
Keyword(s):  
Colorectal Cancer ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Meta Analysis ◽  
Hormone Replacement

Hormone replacement therapy and the risk of colorectal cancer: a meta-analysis

1998 ◽  
Vol 5 (4) ◽  
pp. 165
Author(s):  
Kavita Nanda ◽  
Lori A. Bastian ◽  
Victor Hasselblad ◽  
David L. Simel
Keyword(s):  
Colorectal Cancer ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Meta Analysis ◽  
Hormone Replacement

scholarly journals Association of hormone replacement therapy with mortality in colorectal cancer survivor: a systematic review and meta-analysis

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yeu-Chai Jang ◽  
Hsi-Lan Huang ◽  
Chi Yan Leung
Keyword(s):  
Colorectal Cancer ◽  
Hormone Replacement Therapy ◽  
Cancer Survivors ◽  
Replacement Therapy ◽  
Meta Analysis ◽  
Hormone Replacement ◽  
Colorectal Cancer Survivors ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Overall Mortality

Abstract Background Hormone replacement therapy (HRT) use has shown to be associated with a reduced risk of colorectal cancer, however, its impact on survival among women with colorectal cancer remains uncertain. This meta-analysis aimed to systematically assess the survival benefit of HRT use in patients with colorectal cancer. Methods PRISMA guidelines for the reporting of meta-analyses were followed. We systematically searched PubMed, Embase, Cochrane library, Scopus, and PsycINFO from inception to 12 January 2019, with no language restrictions, for randomized controlled trials and cohort studies reporting the association between hormone replacement therapy and risk of colorectal cancer mortality or all-cause mortality in colorectal cancer survivors. We used the Newcastle-Ottawa Scale to assess the risk of bias of the included studies. We summarized the association as hazard ratio (HR; 95% CI) using random-effects meta-analysis. The study protocol was registered in PROSPERO (CRD42017071914). Results Of 1648 articles identified, five cohorts including 10,013 colorectal cancer survivors were included in this meta-analysis. Compared with women with no prior use of HRT, those reporting current use of HRT had lower risks of colorectal cancer-specific mortality (HR, 0.71 [95% CI, 0.62–0.80], I2 = 0%) and overall mortality (HR, 0.74 [95% CI, 0.67–0.81], I2 = 0%). Low between-study variance was also suggested by the narrow prediction interval for colorectal cancer-specific mortality (0.58–0.86) and overall mortality (0.63–0.87), which indicated that a future study will show survival benefits in women with current HRT use compared with those with no HRT exposure. Inverse associations with colorectal cancer-specific (HR, 1.02 [95% CI, 0.82–1.28], I2 = 0%) and overall mortality (HR, 1.07 [95% CI, 0.90–1.27], I2 = 0%) were not observed for former users of HRT. Sensitivity analyses revealed no differences in the risk estimates between two groups. Conclusions The findings suggest that the current use of HRT is associated with lower risks of colorectal cancer-specific and overall mortality in patients with colorectal cancer. Further investigations to elucidate the underlying mechanism are warranted.

Meta-Analysis

2005 ◽  
Vol 44 (01) ◽  
pp. 127-135 ◽  
Author(s):  
D. Böhning
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Mixed Model ◽  
Unobserved Heterogeneity ◽  
Meta Analysis ◽  
Hormone Replacement ◽  
Large Trial ◽  
Increased Risk ◽  
The One

Summary Objectives: This contribution provides a unifying concept for meta-analysis integrating the handling of unobserved heterogeneity, study covariates, publication bias and study quality. It is important to consider these issues simultaneously to avoid the occurrence of artifacts, and a method for doing so is suggested here. Methods: The approach is based upon the meta-likelihood in combination with a general linear nonparametric mixed model, which lays the ground for all inferential conclusions suggested here. Results: The concept is illustrated at hand of a meta-analysis investigating the relationship of hormone replacement therapy and breast cancer. The phenomenon of interest has been investigated in many studies for a considerable time and different results were reported. In 1992 a meta-analysis by Sillero-Arenas et al. [1] concluded a small, but significant overall effect of 1.06 on the relative risk scale. Using the meta-likelihood approach it is demonstrated here that this meta-analysis is due to considerable unobserved heterogeneity. Furthermore, it is shown that new methods are available to model this heterogeneity successfully. It is argued further to include available study covariates to explain this heterogeneity in the meta-analysis at hand. Conclusions: The topic of HRT and breast cancer has again very recently become an issue of public debate, when results of a large trial investigating the health effects of hormone replacement therapy were published indicating an increased risk for breast cancer (risk ratio of 1.26). Using an adequate regression model in the previously published meta-analysis an adjusted estimate of effect of 1.14 can be given which is considerably higher than the one published in the meta-analysis of Sillero-Arenas et al. [1]. In summary, it is hoped that the method suggested here contributes further to a good meta-analytic practice in public health and clinical disciplines.

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