Women fare better than men with metastatic colorectal cancer—are hormones helping?

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Younger women with metastatic colorectal cancer lived longer than younger men. However, this survival advantage disappeared with age, suggesting a benefit from estrogen or other hormones, according to results of a study published in Clinical Cancer Research, a journal of the American Association for Cancer Research.

“We’ve known for a while that estrogen prevents colorectal cancer, but this is the first study to suggest it may improve outcomes once you have colorectal cancer,” said Heinz-Josef Lenz, M.D., co-director of gastrointestinal oncology and colorectal cancer at the University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine.

Using the Surveillance, Epidemiology and End Results registry, Lenz and colleagues screened 52,882 patients who had metastatic colorectal cancer between 1988 and 2004. 

Women age 18 to 44 years had significantly longer survival than men — at 17 months compared with 14 months. However, older women had significantly shorter overall survival at seven months compared with nine months.

Lenz said these results suggest that estrogen levels may be playing a significant role in prognosis. James Abbruzzese, M.D., chair of gastrointestinal medical oncology at the University of Texas M. D. Anderson Cancer Center and a deputy editor of Clinical Cancer Research, agreed that hormones may certainly play a role, but says a look at the data broken down by year is also intriguing. Specifically, those diagnosed after 2000 have improved survival; those diagnosed before 2000 had a less pronounced survival advantage.

“In terms of the chemotherapy we have available, since 2000 the regimens employ more agents and have become much more aggressive. Therefore, it may be expected to inhibit normal hormonal cycles leading to lower hormonal levels in these women, so other factors may be playing a role as well. It may not just be hormones,” said Abbruzzese.

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The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The membership includes 30,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and nearly 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants, research fellowship and career development awards. The AACR Annual Meeting attracts more than 16,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes six major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers & Prevention; and Cancer Prevention Research. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy. 

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