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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

The effect of estrogen vs combined estrogen-progestogen therapy on the risk of colorectal cancer

Review published: 2012.

Bibliographic details: Lin KJ, Cheung WY, Lai JY, Giovannucci EL.  The effect of estrogen vs combined estrogen-progestogen therapy on the risk of colorectal cancer. International Journal of Cancer 2012; 130(2): 419-430. [PubMed: 21365647]

Quality assessment

The authors concluded that overall there was consistent evidence to support an association between oestrogen-progestogen therapy and colorectal risk reduction. The analyses suggested that only current use of oestrogen therapy was associated with a decreased risk of colorectal cancer.The authors conclusions reflect the evidence presented but their reliability is uncertain due to methodological weaknesses in the review. Full critical summary

Abstract

Studies suggest that estrogen therapy (ET) and combined estrogen-progestogen therapy (EPT) may have different associations with colorectal cancer (CRC) risk, but data are conflicting. Prior meta-analyses did not distinguish between ET and EPT. We conducted a meta-analysis to summarize the relative risks (RR) of CRC due to ET versus EPT among peri- or postmenopausal women. From a total of 2,661 articles, four randomized controlled trials, eight cohort and eight case-control studies were included. Variables assessed included study characteristics, duration and recency of menopausal hormone therapy (HT) use, method of assessment of HT use, outcome definition and its ascertainment method. RRs were synthesized by random-effects models. We found that EPT ever use was associated with a decreased risk of CRC (RR 0.74, 95% CI 0.68-0.81), and so was ET ever use (RR 0.79, 95% CI 0.69-0.91). While current use of ET was associated with a significantly reduced risk of CRC (RR 0.70, 95% CI 0.57-0.85), former use was not (RR 0.86, 95%CI 0.67-1.11). Recency did not significantly modify the association between EPT and CRC risk. EPT former use was associated with a lower RR of CRC compared to ET former use (p = 0.008) but no such difference was observed between EPT and ET current use (p = 0.12). Overall, we found consistent evidence supporting the association between EPT and CRC risk reduction, regardless of recency. While literature for the association between ET and CRC risk is heterogeneous, our analyses suggest only current use of ET is associated with a decreased CRC risk.

Copyright © 2011 UICC.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

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