OBJECTIVES: It is noticed that the incidence of hepatoma in females was generally lower compared to males. The sex differences have been attributed to estrogen. However, information on the incidence of HCC in postmenopausal women receiving estrogen is still lacking. We aimed to evaluate the relationship between HT and the HCC risk in postmenopausal women with HBV, and also investigate the cumulative incidences of HCC.

METHODS: We used the Large Health Insurance Dataset (LHID) in Taiwanese National Health Insurance claims databases to establish research cohorts. The clinical dataset consist 3 million adult patients from 1997 to 2012. We excluded male, aged 50 years younger, and any previous cancer, then established two cohorts (HT and non-HT users) in postmenopausal women which are aged≧50 years between 1 January 1997 and 31 December 2012 and diagnosis with HBV. 3,333 postmenopausal women with HBV for at least 90 days HT (HT group) and 10,458 untreated postmenopausal women with HBV (non-HT group), who never received HT or less than 90 days were matched 1:4 based on propensity scores. A cohort study (n=14,713) was conducted among this population to estimate the association between the 10-year cumulated incidence of HCC and exposure to HT by Cox’s proportion hazard model, and multivariable analyses using conditional logistic regression were executed after adjusting for hazard ratios (HR) and competing mortality.

RESULTS: Insurance claim data presents that the treated cohort had a significantly lower 10 years incidence of HCC (3.05%; 95% confidence interval [CI], 1.54% - 4.55%) than non-treated cohort (5.65%; 95% CI, 4.64%-6.65%; P <0.05). Hormone therapy was associated with a reduced risk of HCC, with an adjusted hazard ratio of 0.58 (95%CI, 0.38-0.9; P<0.05), after adjusting for other confounders and competing mortality. Cirrhosis modified this association.

CONCLUSIONS: We highlight emerging evidence that HT therapy was associated with a decreased risk of HCC among postmenopausal women with HBV.