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The impact of hormone replacement therapy on cancer

Principal Investigator
Name
Zhaoyu Li
Degrees
Ph.D.
Institution
University of Western Australia
Position Title
Head of Cancer Research Cluster
Email
About this CDAS Project
Study
PLCO (Learn more about this study)
Project ID
PLCO-883
Initial CDAS Request Approval
Dec 30, 2021
Title
The impact of hormone replacement therapy on cancer
Summary
This study aims to investigate the impact of hormone replace therapy on cancer incidence and therapeutic outcomes. Hormone replacement therapy including both estradiol alone and the combinations of estradiol with progesterone have been broadly used for menopausal women. A few previous studies have shown that hormone replacement therapy either prevent or promote certain types of cancers, and either benefit or impair cancer therapy, based on small cohorts of retrospective studies. With the large cohorts of PLCO data, we expect to draw a more solid conclusion regarding the impact of hormone replacement therapy on cancer incidence and outcomes for all cancer types included in the PLCO cohorts. In the long run, we expect to develop novel cancer prevention approaches based on hormone replacement therapy or anti-hormone replacement therapy and develop novel biomarkers for early detection, diagnosis, and prognosis of cancers using the blood samples collected in the PLCO cohorts.
Aims

Aim 1: To investigate the impact of hormone replacement therapy on cancer incidence
We request to access the cancer diagnosis data from those women or men who received hormone replacement therapy in the PLCO cohorts. Next, we will conduct the correlation analysis of cancer incidence and hormone replacement therapy between those people who received hormone replacement therapy with and without cancer and also calculate t the adjusted odds ratio and 95% confidence interval values, using maximum likelihood estimation after controlling for confounding effect of demographic factors like age, gender, BMI, disease history, length of hormone replacement therapy, etc. With such correlation analyses, we expect to address the impact of hormone replacement therapy on the incidence of each cancer type and subtype and also for all cancer types in general.

Aim 2: To investigate the impact of hormone replacement therapy on the outcomes of cancer treatment
We request to access the survival data for those people who received hormone replacement therapy in the PLCO cohorts. Next, we will calculate the overall survival that will be defined as the time between cancer diagnosis and death or end of follow-up. Median survival will be estimated by using the Kaplan-Meier product-limit method, and significant differences between the survival times will be determined by using the log-rank test. To identify independent prognostic factors for overall survival, hazard ratios, and 95% CIs will be calculated by using Cox proportional hazard models with a backward stepwise selection. From these analyses, we expect to address we expect to address the impact of hormone replacement therapy on the outcomes of each cancer type and subtype and also for all cancer types in general.

Collaborators

Dr. Nina McCarthy, University of Western Australia
Prof. Martha Hickey, University of Melbourne
Prof. Justin Nguyen, Mayo Clinic