scholarly journals Association of supplemental calcium and dairy milk intake with all-cause and cause-specific mortality in the UK Biobank: a prospective cohort study

2019 ◽  
Vol 123 (5) ◽  
pp. 574-582 ◽  
Author(s):  
L. C. Stasinopoulos ◽  
A. Zhou ◽  
E. Hyppönen
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Cancer Mortality ◽  
Hormone Replacement ◽  
Sensitivity Analyses ◽  
Milk Consumption ◽  
Inverse Association ◽  
Uk Biobank ◽  
Supplement Use ◽  
Increased Risk

AbstractExcessive Ca intakes have been proposed to associate with vascular calcification and a higher risk of prostate cancer. We investigated the associations of supplemental and dietary Ca intake with mortality using data from 497 828 UK Biobank participants. The average follow-up was 4·2 years and 14 255 participants died, 8297 from cancer, 2959 from CVD and 572 from respiratory disease. The use of Ca supplements and milk consumption were associated with differences in mortality in younger (≤65 years) but not in older participants (>65 years, Pinteraction ≤ 0·04 for all comparisons). Among participants <65 years, there was an inverse association between Ca supplementation (OR 0·91, 95 % CI 0·83, 0·99) and milk consumption (OR 0·93, 95 % CI 0·86, 1·00) with respect to all-cause mortality. In the same age group, milk drinkers had lower odds of cancer mortality (OR 0·89, 95 % CI 0·80, 0·98) but Ca supplement use was associated with increased odds of respiratory mortality (OR 1·69, 95 % CI 1·16, 2·74). All associations in participants aged ≥65 years were null after full adjustment. In sensitivity analyses stratified by hormone replacement therapy, Ca supplement use was associated with decreased odds of cancer mortality in users but increased risk in other women (OR 0·81, 95 % CI 0·69, 0·94 v. OR 1·17, 95 % CI 1·01, 1·35, respectively). To conclude, we saw little evidence for harm with dietary or supplemental Ca. Further studies are required to confirm the proposed interaction with hormone replacement therapy and to exclude reverse causation as a determinant in the association between Ca supplements and increased risk of respiratory diseases.

Risks and Benefits of Hormone Replacement Therapy

Cephalalgia ◽  
2000 ◽  
Vol 20 (3) ◽  
pp. 164-169 ◽  
Author(s):  
B de Lignières ◽  
E A MacGregor
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Mortality And Morbidity ◽  
Oestrogen Deficiency ◽  
Disease Mortality ◽  
Increased Risk ◽  
Deficiency Diseases ◽  
Symptomatic Side ◽  
Natural Progesterone

Menopause, the permanent cessation of menstruation, is due to ovarian failure, which may lead to oestrogen deficiency diseases, particularly osteoporosis, cardiovascular disease and cerebrovascular disease. Mortality and morbidity caused by these conditions can be modified by using hormone replacement therapy, but the benefits of this therapy must be weighed against the increased risk of breast cancer and the symptomatic side-effects the treatment may cause. The combination of transdermal oestrogen and natural progesterone offers the most favourable risk-to-benefit profile.

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.

scholarly journals Current Evidence of the Oncological Benefit-Risk Profile of Hormone Replacement Therapy

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 573 ◽  
Author(s):  
Marta D’Alonzo ◽  
Valentina Elisabetta Bounous ◽  
Michela Villa ◽  
Nicoletta Biglia
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Current Evidence ◽  
Conjugated Equine Estrogen ◽  
Colon Cancer Risk ◽  
Increased Risk ◽  
Intact Uterus ◽  
Progestin Therapy

Hormone replacement therapy (HRT) remains the most effective treatment for menopausal symptoms and has been shown to prevent bone loss and fracture. The progestogen is added to provide endometrial protection in women with an intact uterus. After the publication of the initial WHI (Women’s Health Initiative) results in 2002 reporting an overall increased risk of breast cancer, many women discontinued HRT. Despite the re-analysis of the results by subgroups of patients and updates with extended follow-up, much controversy remains, which we will analyze later in the text. Different types of estrogen or progestogen, as well as different formulations, doses, and durations, may play a role in HRT’s effects on breast tissue. Evidence states that conjugated equine estrogen (CEE), compared to estro-progestin therapy, shows a better profile risk (HR 0.79, CI 0.65–0.97) and that, among different type of progestins, those structurally related to testosterone show a higher risk (RR 3.35, CI 1.07–10.4). Chronic unopposed endometrial exposure to estrogen increases the risk of endometrial hyperplasia and cancer, whereas the association with progestins, especially in continuous combined regimen, seems to reduce the risk (RR 0.71, CI 0.56–0.90). HRT was also associated with a protective effect on colon cancer risk (HR 0.61, CI 0.42–0.87). Data about ovarian and cervical cancer are still controversial.

Hormone Replacement Therapy and Life Expectancy After Prophylactic Oophorectomy in Women With BRCA1/2 Mutations: A Decision Analysis

2004 ◽  
Vol 22 (6) ◽  
pp. 1045-1054 ◽  
Author(s):  
Katrina Armstrong ◽  
J. Sanford Schwartz ◽  
Thomas Randall ◽  
Stephen C. Rubin ◽  
Barbara Weber
Keyword(s):  
Hormone Replacement Therapy ◽  
Life Expectancy ◽  
Decision Analysis ◽  
Replacement Therapy ◽  
Prophylactic Mastectomy ◽  
Hormone Replacement ◽  
Sensitivity Analyses ◽  
Decision Analytic Model ◽  
Prophylactic Oophorectomy ◽  
The Impact

Purpose The decision about prophylactic oophorectomy is difficult for many premenopausal women with BRCA1/2 mutations because of concerns and controversy about the use of hormone replacement therapy (HRT) after oophorectomy. Patients and Methods A Markov decision analytic model used the most current epidemiologic data to assess the expected outcomes of prophylactic oophorectomy with or without HRT (to age 50 years or for life) in cohorts of women with BRCA1/2 mutations. Sensitivity analyses were conducted to assess the impact of alternative assumptions about effects of HRT, effects of prophylactic oophorectomy, and risks of cancer associated with BRCA1/2 mutations. Results In our model, prophylactic oophorectomy lengthened life expectancy in women with BRCA1/2 mutations, irrespective of whether HRT was used after oophorectomy. This gain ranged from 3.34 to 4.65 years, depending on age at oophorectomy. Use of HRT after oophorectomy was associated with relatively small changes in life expectancy (+0.17 to −0.34 years) when HRT was stopped at age 50, but larger decrements in life expectancy if HRT was continued for life (−0.79 to −1.09 years). HRT was associated with a gain in life expectancy of between 0.39 and 0.79 years for mutation carriers undergoing both prophylactic mastectomy and oophorectomy. Conclusion On the basis of the results of this decision analysis, we recommend that women with BRCA1/2 mutations undergo prophylactic oophorectomy after completion of childbearing, decide about short-term HRT after oophorectomy based largely on quality-of-life issues rather than life expectancy, and, if using HRT, consider discontinuing treatment at the time of expected natural menopause, approximately age 50 years.

scholarly journals Hormone replacement therapy and mortality in 52- to 70-year-old women: the Kuopio Osteoporosis Risk Factor and Prevention Study

2006 ◽  
Vol 154 (1) ◽  
pp. 101-107 ◽  
Author(s):  
Kati Pentti ◽  
Risto Honkanen ◽  
Marjo T Tuppurainen ◽  
Lorenzo Sandini ◽  
Heikki Kröger ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Cancer Mortality ◽  
Hormone Replacement ◽  
Breast Cancer Mortality ◽  
Prevention Study ◽  
Osteoporosis Risk

Objectives: To analyze prospectively the association between hormone replacement therapy (HRT) and mortality in women before old age. Design and methods: A group of 11 667 women (91% of the age cohort of the area) aged 52–62 years from the population-based Kuopio Osteoporosis Risk Factor and Prevention Study were followed for 7 years in 1994–2001. Information about HRT use and health events was obtained from two repeated questionnaires in 1989 and 1994. Information about deaths and causes of death from the follow-up period was obtained from the Statistics Finland. Cox’s proportional-hazards models were used to calculate risk of death related to the use of HRT. Results: At the start of follow-up, 2203 women had used HRT >5 years, 3945 women ≤5 years and 5519 women had never used it. During the follow-up, 361 deaths occurred. Compared with non-users of HRT, the adjusted hazard ratio (HR) of death from any cause was 1.05 (95% confidence interval (CI) 0.80–1.36) in women who used HRT ≤5 years and 1.06 (95% CI 0.78–1.46) in women who used HRT >5 years. The adjusted HR for coronary heart disease (CHD) mortality in women who used HRT ≤5 years was 0.79 (95% CI 0.36–1.73), and in women who used HRT >5 years, 2.16 (95% CI 0.93–4.98). For breast cancer mortality the adjusted HR for ≤5 years of HRT use was 0.96 (95% CI 0.32–2.82) and 2.62 (95% CI 0.98–7.00) for >5 years of HRT use. Conclusions: History of HRT use does not affect overall or CHD mortality in women. More than 5 years of HRT use may increase the risk of breast cancer mortality.

scholarly journals Increased Risk of Recurrence After Hormone Replacement Therapy in Breast Cancer Survivors

2008 ◽  
Vol 100 (7) ◽  
pp. 475-482 ◽  
Author(s):  
L. Holmberg ◽  
O.-E. Iversen ◽  
C. M. Rudenstam ◽  
M. Hammar ◽  
E. Kumpulainen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement Therapy ◽  
Cancer Survivors ◽  
Replacement Therapy ◽  
Breast Cancer Survivors ◽  
Hormone Replacement ◽  
Risk Of Recurrence ◽  
Increased Risk
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