Journal article
Estrogen alone and health outcomes in black women by African ancestry: a secondary analyses of a randomized controlled trial
Menopause (New York, N.Y.), Vol.24(2), pp.133-141
02/01/2017
DOI: 10.1097/GME.0000000000000733
PMCID: PMC5266648
PMID: 27749739
Abstract
Objective: In postmenopausal black women in the Women's Health Initiative randomized trial, estrogen alone reduced breast cancers but its comprehensive influence on health outcomes in black women is unknown. Therefore, we examined this issue in the Women's Health Initiative overall and by African ancestry.
Methods: A total of 1,616 black women with prior hysterectomy, including 1,061 with percent African ancestry determination, at 40 US centers were randomly assigned to conjugated equine estrogen (0.625 mg/d) or placebo for 7.2 years' (median) intervention with 13 years' cumulative follow-up. Coronary heart disease (CHD) and breast cancer were primary efficacy and safety outcomes, respectively. A global index also included stroke, colorectal cancer, hip fracture, pulmonary embolism, and death.
Results: Black women in the estrogen-alone group compared with black women in the placebo group had fewer breast cancers (17 vs 40, hazard ratio [HR] 0.47, 95% CI 0.26-0.82). In women with more than 80% African ancestry, breast cancer HR was lower (0.32, 95% CI 0.12-0.86, trend P = 0.04 for ancestry effect). Most other outcomes including CHD, stroke, hip fracture, and the global index were null with estrogen use in black women; a global index effect was more favorable in younger black women (HR 0.65, 95% CI 0.43-0.98).
Conclusions: In black postmenopausal women with prior hysterectomy, estrogen alone significantly reduced breast cancer incidence with no adverse influence on CHD, venous thromboembolism, or all-cause mortality. Favorable estrogen-alone global index effects in younger black women warrant further study.
Details
- Title: Subtitle
- Estrogen alone and health outcomes in black women by African ancestry: a secondary analyses of a randomized controlled trial
- Creators
- Rowan T. Chlebowski - The Lundquist InstituteWendy Barrington - Fred Hutchinson Canc Res Ctr, Div Publ Hlth Issues, 1124 Columbia St, Seattle, WA 98104 USAAaron K. Aragaki - Fred Hutch Cancer CenterJoAnn E. Manson - Brigham and Women's HospitalGloria Sarto - University of Wisconsin–MadisonMary J. O'Sullivan - University of MiamiDaniel Wu - Harbor–UCLA Medical CenterJane A. Cauley - University of PittsburghLihong Qi - University of California, DavisRobert L. Wallace - University of IowaRoss L. Prentice - Fred Hutch Cancer Center
- Resource Type
- Journal article
- Publication Details
- Menopause (New York, N.Y.), Vol.24(2), pp.133-141
- DOI
- 10.1097/GME.0000000000000733
- PMID
- 27749739
- PMCID
- PMC5266648
- NLM abbreviation
- Menopause
- ISSN
- 1072-3714
- eISSN
- 1530-0374
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Grant note
- N01WH22110; 24152; 32100-2; 32105-6; 32108-9; 32111-13; 321115; 32118-32119; 32122; 42107-26; 42129-32; 44221 / National Heart, Lung, and Blood Institute at the National Institutes of Health, U.S. Department of Health and Human Services; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) N01WH032111 / WOMEN'S HEALTH INITIATIVE - OFFICE OF THE DIRECTOR NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 02/01/2017
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984363629302771
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