title: Reproductive and hormonal factors and mortality among women with colorectal cancer in the NIH-AARP Diet and Health Study.
abstract: BACKGROUND
  Although use of menopausal hormone therapy (MHT) and some reproductive factors have been associated with colorectal cancer (CRC) risk, relations between these factors and survival after CRC diagnosis are unclear.
  
  
  METHODS
  Among 2053 post-menopausal women diagnosed with incident CRC in the NIH-AARP Diet and Health Study, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using multivariable Cox proportional hazards regression to test associations between oral contraceptive (OC) use, menarche age, age at first birth, parity, menopausal age, and MHT use with all-cause and CRC-specific mortality.
  
  
  RESULTS
  There were 759 deaths (332 CRC-related deaths) over a median follow-up of 7.7 years. We observed no statistically significant associations between OC use, menarche age, age at first birth, parity, menopausal age, and mortality. Compared with never MHT use, former use was not associated with mortality, but we found an inverse association among baseline current users, for both all-cause (HR=0.79, 95% CI 0.66-0.94) and CRC mortality (0.76, 0.59-0.99).
  
  
  CONCLUSIONS
  Future studies should further focus on the mechanisms by which exogenous oestrogen exposure might affect tumour progression and CRC survival.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA.
authors.forename: H
authors.initials: H
authors.lastname: Arem
authors.affiliation: Division of Public Health Sciences, Washington University School of Medicine in St. Louis, 660 S. Euclid Avenue, Campus Box 8100, St Louis, MO 63110, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Park
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Felix
authors.affiliation: Division of Oncology/Hematology, Winthrop University Hospital, 259 First Street, Mineola, NY 11501, USA.
authors.forename: A
authors.initials: A
authors.lastname: Zervoudakis
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Brinton
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Matthews
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, 2 Norfolk Place, London W2 1PG, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Gunter
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000401:mortality*; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D004032:Diet; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008572:Menarche / Q000502:physiology; D008875:Middle Aged; D010298:Parity; D017698:Postmenopause / Q000097:blood / Q000187:drug effects; D011247:Pregnancy; D017584:Reproductive History
chemical_list: D003278:Contraceptives, Oral, Hormonal; D012739:Gonadal Steroid Hormones