abstract: Postmenopausal hormone therapy is associated with a reduced risk of colorectal cancer lacking CDKN1A expression

 http://cancerres.aacrjournals.org/content/early/2012/04/17/0008-5472.CAN-11-2619.abstract
  
Abstract

Experimental studies have shown that estrogen- or progesterone-activated signaling leads to growth inhibition effects on colon cancer cells through the upregulation of several cell cycle regulators. However, epidemiologic studies evaluating hormone therapy (HT) use and colorectal cancer risk by the status of cell cycle regulators are lacking. In this study, we used data from the prospective Nurses' Health Study to evaluate whether the association between HT use and colorectal cancer risk differs by the molecular pathological status of microsatellite instability (MSI) and expression of cell cycle-related tumor biomarkers, including CDKN1A (p21, CIP1), CDKN1B (p27, KIP1), and TP53 (p53) by immunohistochemistry. Duplication Cox regression analysis was used to determine an association between HT use, cancer risk, and specific tumor biomarkers in 581 incident colon and rectal cancer cases that occurred during 26 years of follow-up among 105520 postmenopausal women. We found a difference between HT use and colorectal cancer risk according to CDKN1A expression (p-value for heterogeneity=0.01). Current HT use was associated with a reduced risk for CDKN1A-nonexpressed (multivariate relative risk (RR)=0.61, 95% confidence interval (CI), 0.46-0.82), but not for CDKN1A-expressed (RR=1.32, 95% CI, 0.76-2.31) tumors. The lower risk for CDKN1A-nonexpressed, but not for CDKN1A-expressed cancers was also present among current users of estrogen-alone therapy. We found no significant difference in the relations between HT use and cancer risk according to MSI, CDKN1B, or TP53 status. Together, our molecular epidemiology findings suggest a preventive effect of HT against colorectal carcinogenesis which depends, in part, on loss of cyclin-dependent kinase inhibitor CDKN1A.

abstract: Hormone Therapy and Different Ovarian Cancers: A National Cohort Study (postmenopausal women/does not include reference to clear cell ovarian)

 Blogger's Note: the abstract makes no reference to clear cell ovarian, given the number of women followed this omission (in the abstract) is curious


Hormone Therapy and Different Ovarian Cancers: A National Cohort Study

Abstract

Postmenopausal hormone therapy use increases the risk of ovarian cancer. In the present study, the authors examined the risks of different histologic types of ovarian cancer associated with hormone therapy. 

Using Danish national registers, the authors identified 909,946 women who were followed from 1995–2005. The women were 50–79 years of age and had no prior hormone-sensitive cancers or bilateral oophorectomy. 

Hormone therapy prescription data were obtained from the National Register of Medicinal Product Statistics. The National Cancer and Pathology Register provided data on ovarian cancers, including information about tumor histology......... In an average of 8.0 years of follow up, 2,681 cases of epithelial ovarian cancer were detected. 

Compared with never users, women taking unopposed oral estrogen therapy had increased risks of both serous tumors and endometrioid tumors but decreased risk of mucinous tumors. Similar increased risks of serous and endometrioid tumors were found with estrogen/progestin therapy, whereas no association was found with mucinous tumors. 

Consistent with results from recent cohort studies, the authors found that ovarian cancer risk varied according to tumor histology. The types of ovarian tumors should be given attention in future studies.

open access: PLoS ONE: Hormone Treatment, Estrogen Receptor Polymorphisms and Mortality: A Prospective Cohort Study (in women 65yrs+)

PLoS ONE: Hormone Treatment, Estrogen Receptor Polymorphisms and Mortality: A Prospective Cohort Study

Conclusions/Significance

The risk of mortality was not associated with HT duration, type or age at initiation. It was however not equal across all women, with some women appearing genetically more vulnerable to the effects of HT in terms of their estrogen receptor genotype. These findings, if confirmed in another independent study, may help explain the differential susceptibility of women to the beneficial or adverse effects of HT.

abstract: Hormonal therapy for recurrent low-grade serous carcinoma of the ovary or peritoneum

Hormonal therapy for recurrent low-grade serous carcinoma of the ovary or peritoneum

Objective
To determine whether hormonal therapies have efficacy in patients with recurrent low-grade serous carcinoma of the ovary or peritoneum.

Methods
We searched departmental databases for patients with histologically-confirmed, evaluable, recurrent low-grade serous ovarian or peritoneal carcinoma who received hormonal therapy at our institution between 1989 and 2009. We retrospectively reviewed patients’ medical records for demographic, disease, hormonal therapy, and estrogen receptor and progesterone receptor expression data. We used the Response Evaluation Criteria in Solid Tumors version 1.1 to determine patients’ responses to hormonal therapy. Because patients could have received more than one evaluable hormonal therapy regimen, we chose to define the outcome metric as “patient-regimens.” Median time to disease progression (TTP) and overall survival (OS) were also calculated. Regression analysis was also performed.

Results
We identified 64 patients with recurrent low-grade serous carcinoma of the ovary or peritoneum. Patients’ median TTP and median OS were 7.4 and 78.2 months, respectively. Patients received 89 separate hormonal patient-regimens, which produced an overall response rate of 9% (6 complete responses and 2 partial responses). Sixty-one percent of the patient-regimens resulted in a 6-month progression-free survival duration of at least 6 months. Patient-regimens involving ER +/PR + disease produced a longer median TTP (8.9 months) than patient-regimens involving ER +/PR- disease did (6.2 months;p = 0.053). This difference approached but did not reach statistical significance.

Conclusions
Hormonal therapies have moderate anti-tumor activity in patients with recurrent low-grade serous carcinoma of the ovary or peritoneum. Further study to determine whether ER/PR expression status is a predictive biomarker for this rare cancer subtype is warranted.

Highlights

► Hormonal therapies have moderate anti-tumor activity in women with recurrent low-grade serous carcinoma of the ovary or peritoneum.
► Further study to determine whether ER/PR expression status is a predictive biomarker for this rare cancer subtype is warranted.
► Low-grade serous carcinoma of the ovary or peritoneum is a unique entity.

Bioidentical hormone therapy: Clarifying the misconceptions

full free access: Health Outcomes After Stopping Conjugated Equine Estrogens Among Postmenopausal Women With Prior Hysterectomy, April 6, 2011— JAMA

PLOS Medicine: Promotional Tone in Reviews of Menopausal Hormone Therapy After the Women's Health Initiative: An Analysis of Published Articles

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Original Article Promotional Tone in Reviews of Menopausal Hormone Therapy After the Women's Health Initiative: An Analysis of Published Articles

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Hormone Therapy: The Next Chapter - Harvard Health Publications

Hormone Therapy At Menopause May Pose Breast Cancer Risk — J. Natl. Cancer Inst.

Safety and tolerability of testosterone patch therapy for up to 4 years in surgically menopausal women receiving oral or transdermal oestrogen - abstr

European Menopause and Andropause Society's position statements on post-reproductive health of women

Wyeth paid writers to promote hormone therapy: study | Reuters

media article: New Findings Further Clarify Breast Cancer Risk With Hormone Therapy

“This is evidence that the story is complicated,” said Tanmai Saxena, an M.D./Ph.D. student at the Keck School of Medicine at the University of Southern California. “The benefits of hormone therapy for relief of postmenopausal symptoms among women are clear, but the risks are more complicated than we had previously thought.”

Women's Health Matters Network: News - Study finds almost half of breast cancer patients did not complete hormone therapy

"The study was published online in the Journal of Clinical Oncology on June 28, 2010."

Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement -- Concensus Statement/Review

Conclusions:
The major conclusions related to the overall benefits and risks of MHT expressed as the number of women per 1000 taking MHT for 5 yr who would experience benefit or harm. Primary areas of benefit included relief of hot flashes and symptoms of urogenital atrophy and prevention of fractures and diabetes. Risks included venothrombotic episodes, stroke, and cholecystitis. In the subgroup of women starting MHT between ages 50 and 59 or less than 10 yr after onset of menopause, congruent trends suggested additional benefit including reduction of overall mortality and coronary artery disease. In this subgroup, estrogen plus some progestogens increased the risk of breast cancer, whereas estrogen alone did not. Beneficial effects on colorectal and endometrial cancer and harmful effects on ovarian cancer occurred but affected only a small number of women. Data from the various Women's Health Initiative studies, which involved women of average age 63, cannot be appropriately applied to calculate risks and benefits of MHT in women starting shortly after menopause.
At the present time, assessments of benefit and risk in these younger women are based on lower levels of evidence.

Stopping hormone therapy worse than not starting?: MedlinePlus

Menopausal hormone therapy and risk of colorectal cancer in the European prospective investigation into cancer and nutrition

"Our results show no significant association of estrogen-only or estrogen plus progestin therapy with colorectal cancer risk."

Hormone therapy, DNA methylation and colon cancer-- Carcinogenesis