Elliott AM, Hannaford PC.. Use of exogenous hormones by women and lung cancer: Evidence from the Royal College of General Practitioners’ Oral Contraception Study

Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Center, AB25 2AY Aberdeen, Scotland.
Contraception (Impact Factor: 2.34). 05/2006; 73(4):331-5. DOI: 10.1016/j.contraception.2005.10.003
Source: PubMed


The objective of this study was to assess the risk of lung cancer among women who have used oral contraception or hormone replacement therapy (HRT), especially those exposed to both classes of exogenous hormones.
This study is a nested case-control one using prospectively collected data from the Royal College of General Practitioners' Oral Contraception Study (OCS). The 162 case patients were women with a diagnosis of lung cancer recorded on the OCS database by August 2004. Each case patient was matched with 3 control subjects who were free of the disease at the time of the case patient's diagnosis, of similar age and with similar length of follow-up in the OCS.
Compared with never use, current use of oral contraception was associated with a statistically nonsignificant reduced risk of lung cancer, with an adjusted odds ratio (OR) of 0.47 and a 95% confidence interval (CI) of 0.08-2.95 (OR=0.86 and 95% CI=0.50-1.48 for former use; OR=0.84 and 95% CI=0.49-1.43 for ever use). Similar comparisons for HRT were current use (OR=1.21, 95% CI=0.23-6.37), former use (OR=0.62, 95% CI=0.23-1.68) and ever use (OR=0.71, 95% CI=0.28-1.78). The OR among women who had used both classes of hormones was 0.53 (95% CI=0.16-1.72), as compared with those who had used neither.
Our results are compatible with findings from other studies that suggest that oral contraceptives may reduce the risk of lung cancer. Evidence for a beneficial effect of HRT is less convincing. Further study is needed to determine how long any benefit lasts and whether it is stronger in women exposed to both classes of exogenous hormones. The small number of events occurring in this very large cohort, however, shows that any public health benefit is likely to be marginal.

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    • "Females in studies of Blackman et al., Kabat et al., Liu et al., Olsson et al. and Smith et al. included young females, who were less than 50 years old [13], [16], [18], [20], [27]. Estrogen was used alone as HRT in seven studies [4], [5], [14], [20], [28], [30], [31], estrogen plus progestin were used as HRT in three studies [6], [15], [24] and estrogen or estrogen plus progestin or the combination of both was used in the left 15 studies. The status of oral contraceptive use in patients was also investigated in nine studies [9], [14], [16], [17], [23], [27]–[29], [31]. "
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