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Epidemiologic studies of hormone therapy (HT) and colorectal cancer incidence consistently show an inverse association; however, few studies considered prediagnostic use of HT on mortality among colorectal cancer patients. We evaluated the relationship of HT and survival among a population-based cohort of women with large bowel cancer. Cases (n=1297) were newly diagnosed with invasive cancer of the colon or rectum, aged 40-74 years at diagnosis, who were identified by Wisconsin’s statewide registry (1988-1991; 1997-2001) for two case-control studies. Information on HT use and other colorectal cancer risk factors was collected by standardized interview. There were 507 deaths (274 of these attributable to colorectal cancer) over 8.4 years of follow-up through December 2005. Hormone use was not associated with colorectal cancer mortality (Adjusted hazard rate ratio=1.09, confidence interval=0.81-1.47). Colorectal cancer specific mortality was not associated with HT when considered separately by preparation type or combined. Stage did not modify this relationship. Long-term HT was weakly positively associated with increased mortality after diagnosis of proximal colon, but not distal colon cancer. Because we detected no differences in survival among users of HT compared to non-users, the results suggest that HT use may affect the incidence of only some colorectal tumors.

We conducted a population-based case–control study to investigate the association between hormone therapy (HT) and ovarian cancer incidence, and followed all these cancer cases to determine the association of HT use with ovarian cancer mortality. Seven hundred fifty-one incident cases of invasive epithelial ovarian cancer aged 40–79 years were diagnosed in Massachusetts and Wisconsin between 1993–1995 and 1998–2001 and matched to similarly aged controls (n = 5,808). Study subjects were interviewed by telephone, which ascertained information on HT use and specific preparation, estrogen alone (E-alone) or estrogen plus progestin (EP). Ovarian cancer cases were followed-up for mortality through December 2005. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals (CI) for ovarian cancer incidence, and Cox proportional hazards modeling was used to estimate hazard ratios and corresponding confidence intervals for ovarian cancer mortality. Ever use of HT was significantly associated with an increased risk of ovarian cancer (odds ratio 1.57, 95% CI 1.31–1.87). The excess risk was confined to women who used E-alone preparations (OR 2.33, 95% CI 1.85–2.95). No significant associations were detected between pre-diagnosis HT use and ovarian cancer survival. Hormone therapy increases risk of ovarian cancer among E-alone users, but there is no substantial impact on survival after diagnosis.

Although overweight body mass is an established risk factor for colorectal cancer incidence, few studies have examined the association between body mass index (BMI) and mortality after colorectal cancer diagnosis. We examined survival in a group of postmenopausal women according to BMI.Using the Wisconsin Cancer Reporting System we identified and enrolled 633 postmenopausal women aged 38-74 years who were diagnosed with colorectal cancer in 1988-1991. These women were interviewed by telephone; vital status was ascertained via Wisconsin death certificates. Cox proportional hazards regression was used to estimate multivariate risks of colorectal cancer-specific and all-cause mortality.Both underweight (BMI20.0 kg/m2) (Hazard Ratio (HR) 2.3, 95% Confidence Interval (CI) 1.0-5.4) and obese (BMIor = 30.0 kg/m2) women (HR 2.1, 95% CI 1.1-3.8) were at increased risk of colon cancer death, as compared to normal weight women (BMI 20.0-24.9 kg/m2). No association was observed for those with rectal cancer. Approximately 50% increases in all-cause mortality were observed among underweight and obese women with colorectal cancer. Postmenopausal hormone use did not appear to modify these associations.Underweight and obese postmenopausal women with colon cancer were at increased risk of death, though comorbidities may partially account for this risk.