Hormone replacement therapy and cancer survival: a longitudinal cohort study: protocol paper

Autor: Judith Burchardt, Ashley K Clift, Winnie Xue Mei, Christopher Cardwell, Sharon Dixon, Julia Hippisley-Cox, Pui San Tan, Carol Coupland, Tom Alan Ranger
Rok vydání: 2021
Předmět:
medicine.medical_treatment
Cohort Studies
0302 clinical medicine
Neoplasms
Epidemiology
Longitudinal Studies
030212 general & internal medicine
Young adult
cancer survival
education.field_of_study
Estrogen Replacement Therapy
Hormone Replacement Therapy - adverse effects
Hormone replacement therapy (menopause)
General Medicine
Middle Aged
Cardiovascular Diseases
030220 oncology & carcinogenesis
oncology
Medicine
epidemiology
Female
Public Health
sex steroids & HRT
Cohort study
Adult
medicine.medical_specialty
Adolescent
Hormone Replacement Therapy
Population
Breast Neoplasms
Young Adult
03 medical and health sciences
SDG 3 - Good Health and Well-being
medicine
Humans
Cardiovascular Diseases - epidemiology
education
Aged
business.industry
Proportional hazards model
Cancer
Estrogen Replacement Therapy - adverse effects
medicine.disease
Emergency medicine
business
Body mass index
Zdroj: BMJ Open, Vol 11, Iss 8 (2021)
BMJ Open
Ranger, T A, Burchardt, J, Clift, A K, Mei, W X, Coupland, C, Tan, P S, Dixon, S, Cardwell, C R & Hippisley-Cox, J 2021, ' Hormone replacement therapy and cancer survival: a longitudinal cohort study: protocol paper ', BMJ Open, vol. 11, no. 8, e046701 . https://doi.org/10.1136/bmjopen-2020-046701
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2020-046701
Popis: IntroductionHormone replacement therapy (HRT) can help women experiencing menopausal symptoms, but usage has declined due to uncertainty around risks of cancer and some cardiovascular diseases (CVD). Moreover, improved cancer survival rates mean that more women who survive cancer go on to experience menopausal symptoms. Understanding these relationships is important so that women and their clinicians can make informed decisions around the risks and benefits of HRT. This study’s primary aim is to determine the association between HRT use after cancer diagnosis and the risk of cancer-specific mortality. The secondary aims are to investigate the risks of HRT on subsequent cancer, all-cause mortality and CVD.Methods and analysisWe will conduct a population-based longitudinal cohort study of 18–79 year-old women diagnosed with cancer between 1998 and 2020, using the QResearch database. The main exposure is HRT use, categorised based on compound, dose and route of administration, and modelled as a time-varying covariate. Analysis of HRT use precancer and postcancer diagnosis will be conducted separately. The primary outcome is cancer-specific mortality, which will be stratified by cancer site. Secondary outcomes include subsequent cancer diagnosis, CVD (including venous thrombo-embolism) and all-cause mortality. Adjustment will be made for key confounders such as age, body mass index, ethnicity, deprivation index, comorbidities, and cancer grade, stage and treatment. Statistical analysis will include descriptive statistics and Cox proportional hazards models to calculate HRs and 95% CIs.Ethics and disseminationEthical approval for this project was obtained from the QResearch Scientific Committee (Ref: OX24, project title ‘Use of hormone replacement therapy and survival from cancer’). This project has been, and will continue to be, supported by patient and public involvement panels. We intend to the submit the findings for peer-reviewed publication in an academic journal and disseminate them to the public through Cancer Research UK.
Databáze: OpenAIRE
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