Hormone replacement therapy and survival in lung cancer in postmenopausal women in a rural population

BACKGROUND: Hormone replacement therapy (HRT) may play a role in the development of lung cancer and subsequent survival. Results from studies exploring these issues are inconsistent. A retrospective study in a rural population was conducted to determine whether a history of HRT use is associated with survival of postmenopausal women with lung cancer. METHODS: A retrospective medical chart review of 648 postmenopausal women, diagnosed with a first primary lung cancer between1995 and 2005, was conducted in a regional hospital in Paducah, Kentucky. History of HRT use was collected. Log-rank test and multivariate Cox regression analysis were performed to examine the effects of HRT on survival. RESULTS: The median survival for women with a history of HRT use was 16.4 months, compared with 10.5 months for women without a history of HRT use. However, this difference in survival was not statistically significant (hazard ratio, 1.09; 95% confidence interval, 0.82-1.44). Women with a history of HRT use were younger on average (64.3 years) at diagnosis than women without a history of HRT use (69.5 years, P < .01). Cigarette smoking was adversely associated with survival (P = .03), as were age (P < .01) and TNM stage (P < .01). CONCLUSIONS: In contrast to previous studies, within this population, a history of HRT use in postmenopausal lung cancer patients was not associated with decreased survival. Because most of the published studies on this issue are retrospective, the discrepant findings reflect the complexity of the role of HRT use in the survival of lung cancer patients.