Antiestrogen use in breast cancer patients reduces the risk of subsequent lung cancer: A population-based study |
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| Institution: | 1. Department of Hematology and Oncology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC;2. Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC;3. Center for Prevention of Gynecological Cancer, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC;4. Institute of Medical Sciences, Tzu-Chi University, Hualien, Taiwan, ROC;5. Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan, ROC;6. Department of Public Health, Tzu-Chi University, Hualien, Taiwan, ROC;1. University College London, UK;2. London School of Hygiene and Tropical Medicine, UK;3. MRC Clinical Trials Unit at UCL, London, UK;1. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany;2. Division of Hematology, Thomas Jefferson University, Philadelphia, PA, USA;3. German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany;4. Division of Preventive Oncology, German Cancer Research Center and National Center for Tumor Diseases, Heidelberg, Germany;1. Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan;2. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 7th floor, Boston, MA, 02115 USA;3. Department of Urology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan;1. CESP (Center for Research in Epidemiology and Population Health), INSERM U1018, Cancer and Environment Team, Université Paris-Saclay, Université Paris-Sud, Villejuif, France;2. Registre Général des tumeurs de Calvados, Centre François Baclesse, Caen, France;3. U1086 Inserm UCNB, Cancers and Prevention, Caen, France;4. Centre de Lutte contre le Cancer Jean Godinot, Reims, France;1. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, United States;2. University of Illinois at Chicago Cancer Center, Cancer Control and Population Science Research Program, Chicago, United States;3. Institute for Health Research and Policy, Chicago, United States;4. Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Chicago, United States;5. School of Public Health, University of Alberta, Edmonton, Alberta, Canada;6. University of Illinois at Chicago, Department of Pediatrics, Chicago, United States;7. Survey Research Laboratory, Public Administration, University of Illinois at Chicago, 412 South Peoria Street, Chicago, 60607, United States;8. University of Illinois at Chicago, Department of Medicine, Chicago, United States;9. Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, United States;1. Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France;2. IRD, UMR 5569, HydroSciences, F-34394 Montpellier, France;3. Santé Publique France, French national public health agency, F-94415 Saint-Maurice, France;4. INSERM, Epidemiology and Population Health Research Centre (CESP), U1018, Gender, Sexuality and Health Team, F-94276 Le Kremlin-Bicêtre, France;5. Univ Paris-Sud, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France;6. INED, F-75012 Paris, France |
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| Abstract: | BackgroundThere is accumulating epidemiological and preclinical evidence that estrogen might be a driver of lung cancer. Breast cancer survivors can offer a unique patient cohort to examine the effect of antiestrogen therapy on lung cancer carcinogenesis because many of these women would have received long-term selective estrogen receptor modulators (SERMs) and/or aromatase inhibitors (AIs) as adjuvant treatment. Our hypothesis is that estrogens play a role in lung cancer development, and that antiestrogen therapy would affect the incidence of subsequent lung cancer among breast cancer survivors.MethodsUsing the Taiwan National Health Insurance (NHI) database, the study included 40,900 survivors of non-metastatic breast cancer after primary surgery, and most antiestrogen users complied well with the medication regimen. We evaluate the effect of antiestrogen therapy on the incidence of subsequent lung cancers.ResultsThis population-based study revealed that antiestrogen use in breast cancer patients was associated with a reduced risk of subsequent lung cancer in older patients (≥50 years) (HR 0.73, 95%CI 0.54–0.99) when compared with breast cancer survivors who did not use antiestrogens.ConclusionThe study supports the hypothesis that antiestrogen therapy modifies lung cancer carcinogenesis in older women. Further well-designed clinical trials to explore the potential of antiestrogens in lung cancer prevention and treatment would be worthwhile. |
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| Keywords: | Antiestrogen Tamoxifen SERMs Aromatase inhibitor Breast cancer Lung cancer |
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