Menopausal hormone therapy and risk of esophageal and gastric cancer in a multi-national study
Menée à partir de données de 5 pays nordiques portant sur 195 094 témoins et 19 518 patients atteints d’un cancer de l'oesophage ou de l'estomac, cette étude analyse l'association entre l'utilisation d'un traitement hormonal substitutif de la ménopause et le risque de développer ces maladies
The incidence of esophago-gastric cancer has an age-dependent male predominance mirroring the physiological sex differences in sex hormonal levels. Some research suggests that menopausal hormone therapy (MHT) counteracts these tumors to occur, but larger studies with longer follow-up are needed, which prompted this study.This population-based case-control study included women aged ≥45 years in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) between 1995 to 2020. Prospectively collected data came from national registries for medications, cancer, diagnoses, total populations, and death. MHT-use was categorized as non-use (reference) and three equal-sized groups (tertiles) of defined daily doses (DDDs). Esophago-gastric cancer was divided into esophageal or cardia adenocarcinoma, esophageal squamous cell carcinoma, and gastric adenocarcinoma. Multivariable logistic regression provided odds ratios (OR) with 95% confidence intervals (CI), adjusted for multiple confounders.The study included 19,518 esophago-gastric cancer patients (cases) and 195,094 control participants matched for age, calendar year, and country. Compared to non-use, the adjusted ORs of esophageal or cardia adenocarcinoma were 0.74 (95% CI 0.67-0.81) for low MHT-use (<158 DDDs), 0.68 (95% CI 0.61-0.75) for intermediate MHT-use (158 to 848 DDDs), and 0.68 (95% CI 0.66-0.81) for high MHT-use (>848 DDDs). The corresponding ORs were 0.69 (95% CI 0.62-0.77), 0.70 (95% CI 0.62-0.77), and 0.71 (95% CI 0.64-0.79) for esophageal squamous cell carcinoma, and 0.90 (95% CI 0.84-0.96), 0.85 (95% CI 0.79-0.91), and 0.80 (95% CI 0.74-0.86) for gastric adenocarcinoma.MHT-users seem to have lower odds of developing esophago-gastric cancer.
Journal of the National Cancer Institute , résumé, 2026