Journal of the National Cancer Institute最新文献

{"title":"Menopausal hormone therapy and risk of liver cancer in a swedish population-based cohort study.","authors":"Yongying Huang,Giola Santoni,Jessica L Petrick,Victoria Wocalewski,Ernesto Sparrelid,Shao-Hua Xie","doi":"10.1093/jnci/djag084","DOIUrl":"https://doi.org/10.1093/jnci/djag084","url":null,"abstract":"BACKGROUNDPrevious studies have suggested a potential role of sex hormones in the development of liver cancer. This study aimed to examine whether menopausal hormone therapy (MHT) is associated with a decreased risk of liver cancer by histological type.METHODThis Swedish population-based cohort study included 217,878 women who received MHT in 2006 to 2023 and an age-matched comparison group of 1,089,390 women who did not receive MHT. Cox regression assessed the associations between use of MHT and the risk of two main subtypes of liver cancer, ie, hepatocellular carcinoma and intrahepatic cholangiocarcinoma, with adjustment for smoking- and alcohol-related diagnoses, non-alcoholic fatty liver disease, diabetes or obesity, hysterectomy, use of non-steroidal anti-inflammatory drugs or aspirin, and use of statins.RESULTSMHT users had a decreased risk of hepatocellular carcinoma (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.29 to 0.70). Decreased HRs of hepatocellular carcinoma were indicated both in users of estrogen only (HR 0.42, 95% CI 0.21 to 0.86) and estrogen combined with progestogen (HR 0.49, 95% CI 0.28 to 0.85). The risk reduction in hepatocellular carcinoma was apparently more pronounced in users aged 60 years or older (HR 0.37, 95% CI 0.19 to 0.75). Use of MHT was not associated with the risk of intrahepatic cholangiocarcinoma (HR 0.99, 95% CI 0.72 to 1.36).CONCLUSIONSMHT in women may decrease the risk of hepatocellular carcinoma, but not intrahepatic cholangiocarcinoma.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidepressant adherence and breast cancer recurrence risk in women with major depressive disorder: a retrospective cohort","authors":"Maya Aboumrad, Corinne Joshu, John Jackson, Kala Visvanathan","doi":"10.1093/jnci/djag076","DOIUrl":"https://doi.org/10.1093/jnci/djag076","url":null,"abstract":"Background Women with major depressive disorder (MDD) who develop breast cancer have higher breast cancer recurrence compared to women without MDD. The reason for the higher recurrence is hypothesized to be multifactorial. We sought to determine whether non-adherence to antidepressants is associated with increased recurrence among women with MDD and breast cancer. Methods We established a retrospective cohort of 6,051 women (age ≥ 18 years), with and without MDD, who were diagnosed with early-stage invasive breast cancer between 2010 to 2019 with follow-up through 2022 using medical record data from the United States Veterans Affairs Healthcare System. We assessed antidepressant adherence in women with MDD over two-years prior to breast cancer diagnosis. We evaluated multiple adherence thresholds (proportion of medication days covered), ranging from ≥20%-100%. We used multivariable competing-risks regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the statistical interaction between MDD and antidepressant adherence on recurrence, adjusting for sociodemographic, clinical, and prognostic factors. Results Among women with MDD and breast cancer (N = 1,754), 94% initiated an antidepressant. A threshold of 60% was the minimum adherence level for there to be a statistically meaningful difference in recurrence between non-adherent and adherent women with MDD. Thirty-nine percent were non-adherent at this threshold. The association between MDD and recurrence was highest among women who did not use antidepressants (HR = 2.20; 95%CI = 1.54-3.15), followed by women who were non-adherent (HR = 1.52; 95%CI = 1.24-1.86), and lowest among women who were adherent (HR = 1.19; 95%CI = 0.99-1.42). Conclusion Adherence to antidepressants could potentially reduce recurrence in patients with breast cancer and MDD.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term trends in cancer mortality by rural-urban status, United States, 1969-2023.","authors":"Farhad Islami,Whitney E Zahnd,Daniel Wiese,Hyuna Sung,Elizabeth J Schafer,Rebecca L Siegel,Ahmedin Jemal","doi":"10.1093/jnci/djag047","DOIUrl":"https://doi.org/10.1093/jnci/djag047","url":null,"abstract":"Understanding long-term trends in cancer mortality in rural and urban areas can provide additional insight into factors contributing to rural-urban disparities in cancer mortality and inform public policies. We examined trends in age-standardized cancer mortality rates (overall, lung, colorectal, female breast, and prostate cancers) by urbanicity of county of residence using National Center for Health Statistics data. During 1969-2023, the highest all-cancer mortality rates shifted from large metropolitan areas to nonmetropolitan areas with the smallest urban population. The crossover occurred in the 1990s in males and early 2000s in females, with the rural-urban mortality gap widening in subsequent years. A similar pattern was observed for lung, colorectal, and breast cancer mortality. The shift in the high cancer burden from urban to rural areas likely reflects geographic redistribution of social determinants of health, which underpins the cancer continuum from exposure to risk factors and prevention to access to high-quality diagnosis and treatment.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147478455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician validation of the Medicare measure for potentially avoidable hospital visits after chemotherapy.","authors":"Arthur S Hong,Michael D Dang,Vincent Merrill,Kathryn Anderson,Liyang Yuan,Isabella Joseph,Sadaf Charania,Gloria Lin,Lauren L Taylor,Angela F Bazzell,Aman Narayan,Usamah N Chaudhary,Samar Bhat,Carolina De La Porte,Nkoyo Effiom,Karina Gomez,Pranathi Pilla,D Mark Courtney,Navid Sadeghi,Ethan A Halm","doi":"10.1093/jnci/djag081","DOIUrl":"https://doi.org/10.1093/jnci/djag081","url":null,"abstract":"BACKGROUNDMedicare's OP-35 measure tracks unplanned hospital visits within 30 days of chemotherapy and defines a subset as \"potentially avoidable\" using ∼300 diagnosis codes. Despite widespread adoption in policy and oncology quality reporting, the measure has not been validated with clinician review.METHODSWe identified 14,220 acute hospital visits within 30 days of chemotherapy (2016 to 2023) from 22 hospitals in three health systems (academic, safety-net, community). A 5% stratified random sample of 705 visits underwent blinded review by three clinicians, who adjudicated avoidability and assigned a clinical classification for each visit (eg non-emergent care occurring overnight; non-urgent blood product transfusion; uncontrolled symptoms requiring hospital care). The gold standard definition for an avoidable visit was based on a majority of the clinicians. We assessed the diagnostic characteristics of OP-35 using sensitivity, specificity, accuracy, and area under receiver operator curve (AUROC). We used the clinical classifications to develop a new set of Actionable Categories of avoidability and assessed its diagnostic characteristics.RESULTSClinicians judged 30.2% of visits (213/705) as avoidable. OP-35 classified a similar proportion (30.8%, 217/705), but agreement was low. Sensitivity of OP-35 was 34.7% (95% CI, 28.2 to 41.6), specificity 70.9% (95% CI, 66.7 to 74.8), and accuracy 59.9% (95% CI, 56.2 to 63.6), with AUROC of 0.53. The Actionable Categories classification performed better: sensitivity 89.7%, specificity 85.2%, accuracy 86.5%, AUROC 0.87.CONCLUSIONOP-35 showed poor agreement with clinicians for avoidable hospital visits, raising concerns about its clinical validity. An alternative classification system grouping visits into actionable clinical scenarios offered superior diagnostic accuracy.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco-related urinary biomarkers and lung cancer risk in women, a case-cohort analysis.","authors":"Mahdi Nalini,Katie M O'Brien,Antonia M Calafat,Lanqing Wang,Jun Feng,Christopher M Reese,Baoyun Xia,Julianne Cook Botelho,Yuesong Wang,Tiffany Seyler,Esther J Roh,Nicole A Tashakkori,Aaron Blakney,Kerui Xu,Mitchell H Gail,Benjamin C Blount,Cindy M Chang,Christian C Abnet,Dale P Sandler,Neal D Freedman,Arash Etemadi","doi":"10.1093/jnci/djag078","DOIUrl":"https://doi.org/10.1093/jnci/djag078","url":null,"abstract":"BACKGROUNDThe constituents of tobacco smoke that specifically contribute to lung cancer risk have yet to be fully identified. We evaluated associations between biomarkers of potentially harmful constituents-polycyclic aromatic hydrocarbons (PAHs), tobacco-specific nitrosamines (TSNAs), nicotine, and volatile organic compounds (VOCs)-and lung cancer incidence among US women.METHODSIn a case-cohort study nested within the Sister Study (women aged 35 to 74 years at baseline, enrolled 2003 to 2009), data were obtained for a random subcohort and all remaining incident lung cancers through September 2017 (median follow-up 9.6 years), stratified by race and ethnicity (Hispanic, non-Hispanic Black, non-Hispanic White, others) and smoking status (current, former, never). The analytic sample included 356 cases and 433 non-cases. We quantified 30 biomarkers in baseline urine samples and calculated hazard ratios (HRs) for associations between one-unit increase in biomarker concentrations (log-scale) and lung cancer incidence using weighted Cox regression models adjusted for urinary creatinine and demographic, health, and lifestyle factors.RESULTSAmong women who were currently smoking at enrolment, positive associations were observed for biomarkers of PAHs (naphthalene, phenanthrene, pyrene, fluorene; HRs 1.4 to 5.3), TSNAs (particularly 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK); HRs : 1.3-2.2), and VOCs (xylene, acrylamide, acrylonitrile, 1,2-dibromoethane/vinyl-chloride/ethylene-oxide/acrylonitrile, acrolein, styrene/ethylbenzene, benzene, dimethylformamide/methylisocyanate, 1,3-butadiene, crotonaldehyde, isoprene; HRs : 1.6-4.4). Associations with biomarkers of most PAHs, NNK, xylene, and dimethylformamide/methylisocyanate remained after additional adjustment for smoking frequency, duration, and nicotine metabolites. In women who did not smoke, positive associations were observed for styrene/ethylbenzene and dimethylformamide/methylisocyanate biomarkers.CONCLUSIONExposure to PAHs, TSNAs and several VOCs through tobacco smoking were associated with increased lung cancer risk among women.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147478456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of social determinants of health diagnosis codes with overall survival in Medicare-insured patients with cancer.","authors":"Joshua N Herb,Chung-Yuan Hu,Sharon H Giordano,George J Chang,Rebecca A Snyder","doi":"10.1093/jnci/djag079","DOIUrl":"https://doi.org/10.1093/jnci/djag079","url":null,"abstract":"BACKGROUNDSocial determinants of health (SDOH) impact long-term cancer outcomes. Since 2015, the Centers for Medicare & Medicaid Services recommends using International Classification of Diseases diagnosis codes Z55-Z65 to document specific SDOH. We examined the association of these Z-codes with survival in patients with cancer.METHODSPatients with breast, colorectal, lung, prostate, or pancreatic cancer were identified in the SEER-Medicare database (2016 to 2019). The primary exposure was a Z-code claim in the 12 months before or 6 months after cancer diagnosis. The primary outcome was overall survival. Multivariable Cox regression was performed to examine the association of Z-code claims with overall survival, controlling for demographic and clinical covariates.RESULTSOf 210,093 patients, 4,351 (2.1%) had at least one Z-code claim. The most frequent codes were for problems with social environment (Z60 47.3%) or a primary support group (Z63: 27.2%). Codes were submitted most often by home health agencies (57.8%) and least often by inpatient facilities (1.7%). In adjusted analyses, any Z-code claim was associated with worse survival than was no claim (hazard ratio, 1.09 [95% CI, 1.05-1.14]; p < 0.01), although the associations varied by Z-code.CONCLUSIONSSDOH Z-codes are rarely submitted with billing claims for Medicare patients with cancer. Whether Z-codes reflect the social needs of patients with cancer remains unclear. With current coding, any SDOH Z-code is associated with poor survival in these patients, but individual Z-codes are not consistently associated with survival. Further studies should determine whether SDOH Z-codes enable effective risk adjustment in a value-based healthcare system.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147478457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of beta-blockers on prognostic outcomes in solid cancers: a systematic review and meta-analysis","authors":"Sule Eraslan, Emine Ceren Ayhan, Michael Tvilling Madsen, Erica K Sloan, Ismail Gögenur, Adile Orhan","doi":"10.1093/jnci/djag082","DOIUrl":"https://doi.org/10.1093/jnci/djag082","url":null,"abstract":"Background Beta-blockers are conventionally prescribed for cardiovascular indications and have potential for repurposing in oncology as adrenergic signalling promotes cancer progression. This systematic review and meta-analysis evaluated whether beta-blocker use is associated with improved survival outcomes in patients with all stages of solid cancer. Methods This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines using a predefined (PICO) framework. Four databases (PubMed, Embase, Cochrane Library, and Web of Science) were searched. Eligible studies compared beta-blocker users with non-users and reported survival outcomes in patients with solid cancer. Outcomes included overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), progression-free survival (PFS) and recurrence-free survival (RFS). Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and the Cochrane Risk of Bias 2 tool. Certainty of evidence was evaluated using GRADE. Results A total of 5122 articles were screened; 94 articles were included in the systematic review and 84 in the meta-analysis comprising 603,827 patients. Beta-blocker use in patients with solid cancers was associated with significantly improved OS (HR 0.88, 95% CI: 0.80-0.96) and PFS (HR 0.82, 95%CI: 0.69-0.97). The greatest effects on OS were observed in patients with gastrointestinal (HR 0.84, 95%CI: 0.72-0.98), lung (HR 0.84, 95%CI: 0.71-0.99), and skin cancers (HR 0.81, 95%CI: 0.73-0.89). Effects appeared stronger with post-diagnostic exposure and in certain cancer subtypes, however, heterogeneity and the observational nature of most included studies warrant cautious interpretation. Conclusion Beta-blocker use was associated with improved OS and PFS in patients with solid cancers.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restaging after neoadjuvant FOLFIRINOX for localized pancreatic cancer: a clinical calculator from the Trans-Atlantic Pancreatic Surgery consortium.","authors":"Esther N Dekker,David van Klaveren,Eva M M Verkolf,Roeland F de Wilde,Marc G Besselink,Eileen M O'Reilly,Alessandro Paniccia,Alice C Wei,Amer H Zureikat,Laura R Prakash,Matthew H G Katz,Ching-Wei D Tzeng,Bas Groot Koerkamp, ","doi":"10.1093/jnci/djag024","DOIUrl":"https://doi.org/10.1093/jnci/djag024","url":null,"abstract":"BACKGROUNDRestaging after neoadjuvant chemotherapy aims to assess treatment response, revise prognosis, and guide further management. This study investigated independent prognostic factors for overall survival (OS) after restaging in patients with localized pancreatic adenocarcinoma (PDAC).METHODSIn this retrospective international study, consecutive patients with localized PDAC who received at least one cycle of (m)FOLFIRINOX as first-line therapy were identified. Multivariable Cox regression analysis was performed with a web-based calculator to predict individualized OS.RESULTSThe TAPS cohort included 2338 patients with localized PDAC, of whom 22.6% were potentially resectable, 30.7% borderline resectable, and 46.7% locally advanced at initial staging. Several baseline characteristics remained independent prognostic factors for OS after restaging borderline resectable (HR 1.31 [95% CI 1.14-1.51]), locally advanced (HR 1.78 [95% CI 1.55-2.05]), body/tail tumor (HR 0.79 [95% CI 0.68-0.90]), and baseline WHO performance status of 1 (HR 1.18 [95% CI 1.07-1.30]) or ≥ 2 (HR 1.54 [95% CI 1.20-1.98]). Additional independent factors were metastatic disease at restaging (HR 1.57 [95% CI 1.31-1.87]), post-induction CA19-9 (HR 1.47 [95% CI 1.37-1.57]), ΔCA19-9 (HR 0.83 [95% CI 0.77-0.89]), post-induction tumor size (HR 1.22 [95% CI 1.11-1.35]), and Δtumor size (HR 0.92 [95% CI 0.87-0.98]). Patients were stratified into four risk groups, with 3-year OS after restaging ranging from 6.0% to 65.8%.CONCLUSIONSurvival at restaging after neoadjuvant chemotherapy of patients with localized PDAC is determined by eight patient, tumor and treatment response characteristics. A web-based calculator can inform clinicians and patients about individualized prognosis and guide further management.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthy dietary patterns and survival among men with prostate cancer.","authors":"Binkai Liu,Caroline Himbert,Jane B Vaselkiv,Colleen B Mcgrath,Leeann Lucas,Yiwen Zhang,Chaoran Ma,Mingyang Song,Rebecca E Graff,Edward L Giovannucci,Meir J Stampfer,Konrad H Stopsack,Qi Sun,Lorelei A Mucci","doi":"10.1093/jnci/djag071","DOIUrl":"https://doi.org/10.1093/jnci/djag071","url":null,"abstract":"BACKGROUND AND OBJECTIVEProstate cancer is the second leading cause of cancer death in U.S. men, yet most patients die from other causes. We examined whether adherence to healthy dietary patterns after diagnosis is associated with overall and cause-specific survival.METHODSWe analyzed 6,085 men with prostate cancer (1986 to 2016) in the Health Professionals Follow-up Study. Five dietary patterns-Alternative Healthy Eating Index (AHEI), Mediterranean diet (AMED), DASH, anti-insulinemic, and anti-inflammatory diets-were derived from validated food frequency questionnaires every 4 years. Post-diagnosis scores were cumulatively averaged, and changes from pre- to post-diagnosis were calculated. Multivariable Cox models estimated hazard ratios (HR) and 95% CIs for mortality through 2024.KEY FINDINGS AND LIMITATIONSOver 71,760 person-years, 3,710 deaths occurred (592 prostate cancer, 971 cardiovascular disease [CVD], 2,147 other). Greater post-diagnosis adherence to AHEI (Q5 vs Q1, HR 0.75, 95% CI 0.66 to 0.86) and AMED (HR 0.80, 95% CI 0.70 to 0.92) was associated with lower all-cause mortality. Increased adherence after diagnosis also predicted better survival, particularly for AHEI. Survival benefits were stronger among men with less aggressive disease. Increased AHEI adherence was associated with lower CVD mortality (HR 0.82, 95% CI 0.66 to 1.03), but no associations were observed for prostate cancer-specific survival. Limitations include the observational design and potential residual confounding.CONCLUSIONS AND CLINICAL IMPLICATIONSAdherence to healthy dietary patterns, especially AHEI and AMED, after prostate cancer diagnosis was associated with improved survival, particularly in less aggressive disease. These findings support dietary improvement as a part of survivorship care.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopausal hormone therapy and risk of esophageal and gastric cancer in a multi-national study.","authors":"Victoria Wocalewski,Giola Santoni,Helgi Birgisson,My Von Euler-Chelpin,Joonas H Kauppila,Eivind Ness-Jensen,Shaohua Xie,Jesper Lagergren","doi":"10.1093/jnci/djag072","DOIUrl":"https://doi.org/10.1093/jnci/djag072","url":null,"abstract":"BACKGROUNDThe 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.METHODSThis 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.RESULTSThe 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.CONCLUSIONMHT-users seem to have lower odds of developing esophago-gastric cancer.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}