Reproductive and hormonal factors and mortality among women with colorectal cancer in the NIH-AARP Diet and Health Study

Br J Cancer. 2015 Jul 28;113(3):562-8. doi: 10.1038/bjc.2015.224. Epub 2015 Jun 23.


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).

Conclusion: Future studies should further focus on the mechanisms by which exogenous oestrogen exposure might affect tumour progression and CRC survival.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Age Factors
  • Aged
  • Cohort Studies
  • Colorectal Neoplasms / etiology*
  • Colorectal Neoplasms / mortality*
  • Contraceptives, Oral, Hormonal / therapeutic use*
  • Diet
  • Estrogen Replacement Therapy* / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Gonadal Steroid Hormones / blood
  • Humans
  • Menarche / physiology
  • Middle Aged
  • Parity
  • Postmenopause* / blood
  • Postmenopause* / drug effects
  • Pregnancy
  • Reproductive History*


  • Contraceptives, Oral, Hormonal
  • Gonadal Steroid Hormones