Affiliation:
1. The First Affiliated Hospital of Zhengzhou University
2. Sichuan University
3. Lanzhou University
4. Western New England University
5. Shanghai University of Traditional Chinese Medicine, Anorectal Disease Institute of Shuguang Hospital
Abstract
AbstractBackground The effect of hormone replacement therapy (HRT) on colorectal cancer (CRC) mortality and all-cause mortality remains unclear. We conducted a systematic review and dose‒response meta-analysis to determine the effects of HRT on CRC mortality and all-cause mortality. Methods We searched the PubMed, Embase, and Cochrane Library electronic databases for all relevant studies published until June 2022 to investigate the effects of HRT exposure on survival rates for patients with CRC. Two reviewers independently extracted individual study data and evaluated THE risk of bias among the studies using the Newcastle‒Ottawa Scale. To examine a potential nonlinear relationship between the year of HRT use and CRC mortality, we performed a two-stage random effects dose‒response meta-analysis. RESULTS Ten cohort studies encompassing 480,628 individuals were included. The meta-analysis revealed that HRT was inversely associated with the risk of CRC mortality [hazard ratios (HR) = 0.77, 95% CI (0.68, 0.87), I2 = 69.5%, P < 0.05]. Pooled results from seven cohort studies revealed a significant association between HRT and the risk of all-cause mortality [HR = 0.71, 95% CI (0.54, 0.92), I2 = 89.6%, p < 0.05]. A linear (P for nonlinearity = 0.34) dose‒response analysis showed a 3% decrease in the risk of CRC for each additional year of HRT use; this decrease was significant [HR = 0.97, 95% CI(0.94, 0.99), P < 0.05]. An additional linear (P for nonlinearity = 0.88) dose‒response analysis showed a nonsignificantly decrease in the risk of all-cause mortality for each additional year of HRT use. CONCLUSIONS This study suggests that the use of HRT is inversely associated with all-cause and colorectal cancer mortality, thus causing a significant decrease in mortality rates over time. Further studies are warranted to confirm this association.
Publisher
Research Square Platform LLC
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