Lung Cancer Among Postmenopausal Women Treated With Estrogen Alone in the Women's Health Initiative Randomized Trial
Year: 2010
Type: article
Abstract: BACKGROUND: In the Women's Health Initiative (WHI) randomized controlled trial, use of estrogen plus progestin increased lung cancer mortality. We conducted post hoc analyses in the WHI trial evaluating estrogen alone to determine whether use of conjugated equine estrogen without progestin had a similar adverse influence on lung cancer. METHODS: The WHI study is a randomized, double-blind, placebo-controlled trial conducted in 40 centers in the United States. A total of 10 739 postmenopausal women aged 50-79 years who had a previous hysterectomy were randomly assigned to receive a once-daily 0.625-mg tablet of conjugated equine estrogen (n = 5310) or matching placebo (n = 5429). Incidence and mortality rates for all lung cancers, small cell lung cancers, and non-small cell lung cancers in the two randomization groups were compared by use of hazard ratios (HRs) and 95% confidence intervals (CIs) that were estimated from Cox proportional hazards regression analyses. Analyses were by intention to treat, and all statistical tests were two-sided. RESULTS: After a mean of 7.9 years (standard deviation = 1.8 years) of follow-up, 61 women in the hormone therapy group were diagnosed with lung cancer compared with 54 in the placebo group (incidence of lung cancer per year = 0.15% vs 0.13%, respectively; HR of incidence = 1.17, 95% CI = 0.81 to 1.69, P = .39). Non-small cell lung cancers were of comparable number, stage, and grade in both groups. Deaths from lung cancer did not differ between the two groups (34 vs 33 deaths in estrogen and placebo groups, respectively; HR of death = 1.07, 95% CI = 0.66 to 1.72, P = .79). CONCLUSION: Unlike use of estrogen plus progestin, which increased deaths from lung cancer, use of conjugated equine estrogen alone did not increase incidence or death from lung cancer.
DOI: 10.1093/jnci/djq285
Institutions: University of California, Los Angeles, The Lundquist Institute, Harbor–UCLA Medical Center, Brigham and Women's Hospital, Harvard University, University of California, Irvine, Medical College of Wisconsin, Fred Hutch Cancer Center, The Barbara Ann Karmanos Cancer Institute, University of Cincinnati, University at Buffalo, State University of New York, Stanford University, Wayne State University, University of Tennessee Health Science Center, University of Massachusetts Chan Medical School, University of Miami
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: G109231058, G1107292973, Women's Health Initiative, Women's Health Initiative, G156924709, Women's Health Initiative, G1593340546, G206718646, Women's Health Initiative, G2253702613, G2295046671, G2417273319, G2547046739, G257474614, G2852769941, Women's Health Initiative Memory Study (WHIMS), G3544793024, Women's Health Initiative, G3642616392, Women's Health Initiative, Women's Health Initiative, G413560588, G4216744017, G4281851297, COORDINATING CENTER FOR WOMEN'S HEALTH INITIATIVE, G429396632, G4321061599, G445374210, G4560602636, G484043965, G4940723635, G5183277930, FOR ALL FIELD CENTER FOR WHI EXTENSION, G530368906, G532295152, G555506801, G603760282, G6464247198, Women's Health Initiative, G7066869570, G7071300326, G7223985928, G7272550893, Women's Health Initiative, G7323080267, G7582705761, G8780700017, G8934942062, G9000002220, G9000015938, G9000016408, G9000029166, G9000099044, G9000151586, G9000247497, G999174792
OpenAlex ID: W2138990570