TY - JOUR
T1 - Lung cancer among postmenopausal women treated with estrogen alone in the women's health initiative randomized trial
AU - Chlebowski, Rowan T.
AU - Anderson, Garnet L.
AU - Manson, Joann E.
AU - Schwartz, Ann G.
AU - Wakelee, Heather
AU - Gass, Margery
AU - Rodabough, Rebecca J.
AU - Johnson, Karen C.
AU - Wactawski-Wende, Jean
AU - Kotchen, Jane Morley
AU - Ockene, Judith K.
AU - O'Sullivan, Mary Jo
AU - Hubbell, F. Allan
AU - Chien, Jason W.
AU - Chen, Chu
AU - Stefanick, Marcia L.
N1 - Funding Information:
The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts N01WH22110, 24152, 32100–2, 32105–6, 32108–9, 32111–13, 32115, 32118–19, 32122, 42107–26, 42129–32, and 44221.
Funding Information:
R. T. Chlebowski has received speaker’s fee and honorarium for advisory boards and consulting from AstraZeneca and Novartis; honorarium for advisory boards and consulting for Lilly, Amgen, and Pfizer; and grant support from Amgen. R. T. Chlebowski, G. L. Anderson, M. L. Stefanick, J. E. Manson, J. Wactawski-Wende, M. Gass, J. M. Kotchen, K. C. Johnson, M. J. O’Sullivan, J. K. Ockene, and F. A. Hubbell have received grant support from National Institutes of Health; K. C. Johnson and R. T. Chlebowski additionally have received grant support from the National Cancer Institute of Canada. M. Gass has received grant support from Wyeth. A. G. Schwartz, H. Wakelee, R. J. Rodabough, J. W. Chien, and C. Chen have no conflicts of interest.
PY - 2010/9/22
Y1 - 2010/9/22
N2 - 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 10739 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).ConclusionUnlike 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.
AB - 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 10739 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).ConclusionUnlike 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.
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U2 - 10.1093/jnci/djq285
DO - 10.1093/jnci/djq285
M3 - Article
C2 - 20709992
AN - SCOPUS:77957257347
VL - 102
SP - 1413
EP - 1421
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
SN - 0027-8874
IS - 18
ER -