Rationale Early natural menopause (early-M; <45 years of age) increases the risk of lung morbidities and mortalities in smokers. However, it is largely unknown whether early-M due to surgery demonstrates similar effects and whether menopausal hormone therapy (MHT) is protective against lung diseases. Objectives To assess the associations of early-M and MHT with lung morbidities and mortalities using the prospective Prostate, Lung, Colorectal and Ovarian (PLCO) trial. Methods We estimated the risk among 69 706 postmenopausal women in the PLCO trial, stratified by menopausal types and smoking status. Results Early-M was associated with an increased risk of most lung disease and mortality outcomes in ever smokers with the highest risk seen for respiratory mortality (HR 1.98, 95% CI 1.34 to 2.92) in those with bilateral oophorectomy (BO). Early-M was positively associated with chronic bronchitis, and all-cause, non-cancer and respiratory mortality in never smokers with natural menopause or BO, with the highest risk seen for BO— respiratory mortality (HR 1.91, 95% CI 1.16 to 3.12). Ever MHT was associated with reduced all-cause, non-cancer and cardiovascular mortality across menopause types regardless of smoking status and was additionally associated with reduced risk of non-ovarian cancer, lung cancer (LC) and respiratory mortality in ever smokers. Among smokers, ever MHT use was associated with a reduction in HR for all-cause, non-cancer and cardiovascular mortality in a duration-dependent manner. Conclusions Smokers with early-M should be targeted for smoking cessation and LC screening regardless of menopause types. MHT users had a lower likelihood of dying from LC and respiratory diseases in ever smokers. Data may be obtained from a third party and are not publicly available. Access to the PLCO datasets requires submitting a data-only project using the National Cancer Institute Cancer Data Access system. Data will be delivered once the project is approved and data transfer agreements are completed.

中文翻译：

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早期绝经和激素治疗作为肺部健康结果的决定因素：使用 PLCO 试验的二次分析


基本原理 提前自然绝经（早期 M；<45 岁）会增加吸烟者肺部发病和死亡的风险。然而，目前尚不清楚手术引起的早期 M 是否表现出类似的效果，以及绝经期激素疗法 (MHT) 是否能预防肺部疾病。目的 使用前瞻性前列腺、肺、结直肠和卵巢 (PLCO) 试验评估早期 M 和 MHT 与肺部发病率和死亡率的关联。方法 我们评估了 PLCO 试验中 69 706 名绝经后妇女的风险，按绝经类型和吸烟状况进行分层。结果 Early-M 与曾经吸烟者大多数肺部疾病和死亡结果的风险增加相关，其中双侧卵巢切除术 (BO) 患者的呼吸系统死亡风险最高（HR 1.98，95% CI 1.34 至 2.92）。 Early-M 与慢性支气管炎以及自然绝经或 BO 的从不吸烟者的全因、非癌症和呼吸道死亡率呈正相关，其中 BO 呼吸道死亡率的风险最高（HR 1.91，95% CI 1.16 至 3.12） ）。无论吸烟状况如何，MHT 与各种更年期类型的全因死亡率、非癌症死亡率和心血管死亡率降低相关，并且还与曾经吸烟者的非卵巢癌、肺癌 (LC) 和呼吸系统死亡率风险降低相关。在吸烟者中，曾经使用 MHT 与全因死亡率、非癌症死亡率和心血管死亡率的 HR 降低相关，且呈持续时间依赖性。结论 无论更年期类型如何，患有早期 M 的吸烟者都应成为戒烟和 LC 筛查的目标。与曾经吸烟者相比，MHT 使用者死于 LC 和呼吸系统疾病的可能性较低。 数据可能从第三方获得，并且不公开。访问 PLCO 数据集需要使用国家癌症研究所癌症数据访问系统提交纯数据项目。一旦项目获得批准并完成数据传输协议，数据将被交付。