Early menopause and hormone therapy as determinants for lung health outcomes: a secondary analysis using the PLCO trial.

Autor:	Gai X; Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA., Feng Y; Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA., Flores TM; Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA., Kang H; Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.; Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA., Yu H; Department of Public Health Sciences, University of Miami, Miami, Florida, USA., Leslie KK; Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.; Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA., Zhu Y; Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA., Doherty JA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah, USA., Guo Y; Department of Public Health Sciences, University of Miami, Miami, Florida, USA., Belinsky SA; Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA.; Lung Cancer Program, Lovelace Biomedical Research Institute, Albuquerque, New Mexico, USA., Cook LS; Department of Epidemiology, Colorado School of Public Health, University of Colorado-Anschutz, Aurora, Colorado, USA., Leng S; Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA sleng@salud.unm.edu.; Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA.; Lung Cancer Program, Lovelace Biomedical Research Institute, Albuquerque, New Mexico, USA.
Jazyk:	angličtina
Zdroj:	Thorax [Thorax] 2024 Sep 18; Vol. 79 (10), pp. 961-969. Date of Electronic Publication: 2024 Sep 18.
DOI:	10.1136/thorax-2023-220956
Abstrakt:	Rationale: Early natural menopause (early-M; <45 years of age) increases the risk of lung morbidities and mortalities in smokers. However, it is largely unknown whether early-M due to surgery demonstrates similar effects and whether menopausal hormone therapy (MHT) is protective against lung diseases. Objectives: To assess the associations of early-M and MHT with lung morbidities and mortalities using the prospective Prostate, Lung, Colorectal and Ovarian (PLCO) trial. Methods: We estimated the risk among 69 706 postmenopausal women in the PLCO trial, stratified by menopausal types and smoking status. Results: Early-M was associated with an increased risk of most lung disease and mortality outcomes in ever smokers with the highest risk seen for respiratory mortality (HR 1.98, 95% CI 1.34 to 2.92) in those with bilateral oophorectomy (BO). Early-M was positively associated with chronic bronchitis, and all-cause, non-cancer and respiratory mortality in never smokers with natural menopause or BO, with the highest risk seen for BO- respiratory mortality (HR 1.91, 95% CI 1.16 to 3.12). Ever MHT was associated with reduced all-cause, non-cancer and cardiovascular mortality across menopause types regardless of smoking status and was additionally associated with reduced risk of non-ovarian cancer, lung cancer (LC) and respiratory mortality in ever smokers. Among smokers, ever MHT use was associated with a reduction in HR for all-cause, non-cancer and cardiovascular mortality in a duration-dependent manner. Conclusions: Smokers with early-M should be targeted for smoking cessation and LC screening regardless of menopause types. MHT users had a lower likelihood of dying from LC and respiratory diseases in ever smokers. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu