Goals/Background: 

Hormone replacement therapy (HRT) and parity have been suggested protective factors against the development of colorectal polyps. However, there are a limited number of studies that have examined the relationship of these factors with high-risk adenomatous polyps (HRAP) or high-risk serrated polyps (HRSP), which may have different causes and therefore implications for screening programs.

Study: 

Data from a cross-sectional study of 1384 women undergoing screening-related colonoscopy between 2008 and 2016 were analyzed. Modified Poisson regression models with robust error variance were used to determine the relative risk of developing adenomatous polyps, serrated polyps, HRAPs, and HRSPs associated with pregnancy, menopausal status, and the use of HRT (duration and type).

Results: 

Women that used HRT for ≥6 years were at a significantly lower risk of developing a HRSP [risk ratios (RR): 0.53; 95% confidence interval (CI): 0.29-0.97]. Irrespective of the duration of use, the use of HRT that included progesterone alone or with estrogen was associated with a significantly lower risk of developing a HRSP (RR: 0.54; 95% CI: 0.30-0.95). The use HRT with progesterone for ≥6 years was associated with a nonsignificant lower risk of developing a HRSP (RR: 0.42; 95% CI: 0.17-1.04). None of the reproductive factors assessed or HRT were associated with the development of adenomatous polyps or HRAPs.

Conclusions: 

The results of this study suggests that the long-term use of HRT, and therapies that include progesterone are associated with a lower risk of developing HRSPs. These results could have implications for targeted screening for serrated polyps among women.

中文翻译：

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长期使用激素替代疗法可降低女性患高危锯齿状息肉的风险

目标/背景： 

激素替代疗法（HRT）和产次被认为是预防结直肠息肉发展的保护因素。然而，检查这些因素与高危腺瘤性息肉 (HRAP) 或高危锯齿状息肉 (HRSP) 之间关系的研究数量有限，它们可能有不同的原因，因此对筛查计划有影响。

学习： 

对 2008 年至 2016 年间接受筛查相关结肠镜检查的 1384 名女性进行的横断面研究数据进行了分析。使用具有稳健误差方差的修正泊松回归模型来确定与妊娠、绝经状态和 HRT（持续时间和类型）的使用相关的发生腺瘤性息肉、锯齿状息肉、HRAP 和 HRSP 的相对风险。

结果： 

使用 HRT ≥6 年的女性发生 HRSP 的风险显着降低[风险比 (RR)：0.53；95% 置信区间 (CI)：0.29-0.97]。无论使用时间长短，单独使用黄体酮或联合雌激素的 HRT 与发生 HRSP 的风险显着降低相关（RR：0.54；95% CI：0.30-0.95）。使用黄体酮 HRT ≥6 年与发生 HRSP 的风险无显着降低相关（RR：0.42；95% CI：0.17-1.04）。所评估的生殖因素或 HRT 均与腺瘤性息肉或 HRAP 的发展无关。

结论： 

这项研究的结果表明，长期使用 HRT 和包含黄体酮的疗法与发生 HRSP 的风险较低有关。这些结果可能对女性锯齿状息肉的针对性筛查产生影响。