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Epidemiologic studies of hormone therapy (HT) and colorectal cancer incidence consistently show an inverse association; however, few studies have 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=1,297) 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. 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 only the incidence of some colorectal tumors.

Objectives: 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., Methods: 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., Results: Both underweight (BMI <20.0 kg/m2) (Hazard Ratio (HR) 2.3, 95% Confidence Interval (CI) 1.0-5.4) and obese (BMI > or = 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., Conclusions: Underweight and obese postmenopausal women with colon cancer were at increased risk of death, though comorbidities may partially account for this risk.