title: Hormone therapy and lung cancer mortality in women: Systematic review and meta-analysis.
abstract: The mortality of lung cancer presents a significant difference between the sexes. A role of hormone therapy (HT) in lung cancer mortality has been suggested, but the evidence is inconclusive. We sought to elucidate this issue with a meta-analysis. We conducted a systematic literature search in both Pubmed and Embase. Studies that reported the association of HT and mortality of lung cancer cases were included. Pooled hazard ratio (HR) was computed as the effect size to reflect the association between HT and lung cancer mortality. In total, 11 studies were included in the meta-analysis. The pooled HR of HT in relation to lung cancer mortality was 0.97 (95% CI 0.83-1.12, I2=59.2%, p=0.006) in all studies disregarding study design, and it was 0.80 (95% CI: 0.69-0.92, I2=21.4%, p=0.278) in prospective cohort studies. Results of this meta-analysis were robust, and there was no indication of significant differences in association in small and large studies. We observed a protective role of HT use in lung cancer mortality in pooled prospective cohorts, but not in pooled retrospective cohorts and post hoc analyses of randomized controlled trials. Future studies that address smoking, type and time of HT, menopausal status, and histology are warranted.
authors.affiliation: JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Li
authors.affiliation: JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Xiaona
authors.initials: X
authors.lastname: Lin
authors.affiliation: Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
authors.forename: Shaohua
authors.initials: S
authors.lastname: Xie
authors.affiliation: JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: shelly@cuhk.edu.hk.
authors.forename: Lap Ah
authors.initials: LA
authors.lastname: Tse
mesh_terms: D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D011372:Progestins / Q000627:therapeutic use; D011379:Prognosis
chemical_list: D004967:Estrogens; D011372:Progestins
keywords: Estrogen; Hormone therapy; Lung cancer; Mortality; Progestogen; Prognosis