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Early menopause and hormone therapy as determinants for lung health outcomes: a secondary analysis using the PLCO trial.

About this Publication
Title
Early menopause and hormone therapy as determinants for lung health outcomes: a secondary analysis using the PLCO trial.
Pubmed ID
38871464 (View this publication on the PubMed website)
Digital Object Identifier
Publication
Thorax. 2024 Sep 18; Volume 79 (Issue 10): Pages 961-969
Authors
Gai X, Feng Y, Flores TM, Kang H, Yu H, Leslie KK, Zhu Y, Doherty JA, Guo Y, Belinsky SA, Cook LS, Leng S
Affiliations
  • Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
  • Department of Public Health Sciences, University of Miami, Miami, Florida, USA.
  • Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah, USA.
  • Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA.
  • Department of Epidemiology, Colorado School of Public Health, University of Colorado-Anschutz, Aurora, Colorado, USA.
  • Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA sleng@salud.unm.edu.
Abstract

RATIONALE: Early natural menopause (early-M; <45 years of age) increases the risk of lung morbidities and mortalities in smokers. However, it is largely unknown whether early-M due to surgery demonstrates similar effects and whether menopausal hormone therapy (MHT) is protective against lung diseases.

OBJECTIVES: To assess the associations of early-M and MHT with lung morbidities and mortalities using the prospective Prostate, Lung, Colorectal and Ovarian (PLCO) trial.

METHODS: We estimated the risk among 69 706 postmenopausal women in the PLCO trial, stratified by menopausal types and smoking status.

RESULTS: Early-M was associated with an increased risk of most lung disease and mortality outcomes in ever smokers with the highest risk seen for respiratory mortality (HR 1.98, 95% CI 1.34 to 2.92) in those with bilateral oophorectomy (BO). Early-M was positively associated with chronic bronchitis, and all-cause, non-cancer and respiratory mortality in never smokers with natural menopause or BO, with the highest risk seen for BO- respiratory mortality (HR 1.91, 95% CI 1.16 to 3.12). Ever MHT was associated with reduced all-cause, non-cancer and cardiovascular mortality across menopause types regardless of smoking status and was additionally associated with reduced risk of non-ovarian cancer, lung cancer (LC) and respiratory mortality in ever smokers. Among smokers, ever MHT use was associated with a reduction in HR for all-cause, non-cancer and cardiovascular mortality in a duration-dependent manner.

CONCLUSIONS: Smokers with early-M should be targeted for smoking cessation and LC screening regardless of menopause types. MHT users had a lower likelihood of dying from LC and respiratory diseases in ever smokers.

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