Smoking + early menopause increases risk for lung disease, poor outcomes

Among smokers, early menopause is associated with an increased risk for most lung diseases and poor outcomes, according to a study published online June 13 in Thorax.

Xiaochun Gai, M.B.B.S., from the University of New Mexico School of Medicine in Albuquerque, and colleagues assessed whether early menopause due to surgery affects lung morbidities and mortalities and whether menopausal hormone therapy (MHT) is protective against lung diseases. The analysis included data from 69,706 postmenopausal women.

The researchers found that early menopause was associated with an increased risk for most lung disease and mortality outcomes in ever smokers, with the highest risk seen for respiratory mortality (hazard ratio, 1.98) in those with bilateral oophorectomy (BO). There was a positive association between early menopause and chronic bronchitis and all-cause, noncancer, and respiratory mortality in never smokers with natural menopause or BO, with the highest risk seen for BO (respiratory mortality: hazard ratio, 1.91). Across menopause types, ever MHT use was associated with reduced all-cause, noncancer, and cardiovascular mortality, regardless of smoking status. Additionally, MHT was associated with a reduced risk for nonovarian cancer, lung cancer, and respiratory mortality in ever smokers. Among smokers, there was an association between ever MHT use and a reduction in hazard ratio for all-cause, noncancer, and cardiovascular mortality in a duration-dependent manner.

"Smokers with early menopause should be targeted for smoking cessation and lung cancer screening regardless of menopause types," the authors write.

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