Document Detail


Is estrogen plus progestin menopausal hormone therapy safe with respect to endometrial cancer risk?
MedLine Citation:
PMID:  22553145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Given the strong link between use of unopposed estrogens and development of endometrial cancers, estrogens are usually prescribed with a progestin, particularly for women with intact uteri. Some studies suggest that sequential use of progestins may increase risk; however, the moderating effects of usage patterns or patient characteristics, including body mass index (BMI), are unknown. We evaluated menopausal hormone use and incident endometrial cancer (n = 885) in 68,419 postmenopausal women with intact uteri enrolled in the National Institutes of Health-American Association of Retired Persons Diet and Health study. Participants completed a risk factor questionnaire in 1996-1997 and were followed up through 2006. Hazard rate ratios (RRs) and 95% confidence intervals (CIs) were estimated using Cox regression. Among 19,131 women reporting exclusive estrogen plus progestin use, 176 developed endometrial cancer (RR = 0.88; 95% CI = 0.74-1.06). Long-duration (≥ 10 years) sequential (<15 days progestin per month) estrogen plus progestin use was positively associated with risk (RR = 1.88; 95% CI = 1.36-2.60], whereas continuous (>25 days progestin per month) estrogen plus progestin use was associated with a decreased risk (RR = 0.64; 95% CI = 0.49-0.83). Increased risk for sequential estrogen plus progestin was seen only among thin-to-normal weight women (BMI < 25 kg/m(2); RR = 2.53). Our findings support that specific categories of estrogen plus progestin use increases endometrial cancer risk, specifically long durations of sequential progestins, whereas decreased endometrial cancer risk was observed for users of short-duration continuous progestins. Risks were highest among thin-to-normal weight women, presumably reflecting their lower endogenous estrogen levels, suggesting that menopausal hormones and obesity increase endometrial cancer through common etiologic pathways.
Authors:
Britton Trabert; Nicolas Wentzensen; Hannah P Yang; Mark E Sherman; Albert R Hollenbeck; Yikyung Park; Louise A Brinton
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural     Date:  2012-08-30
Journal Detail:
Title:  International journal of cancer. Journal international du cancer     Volume:  132     ISSN:  1097-0215     ISO Abbreviation:  Int. J. Cancer     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-11-21     Completed Date:  2013-02-07     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  0042124     Medline TA:  Int J Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  417-26     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 UICC.
Affiliation:
Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20852, USA. britton.trabert@nih.gov
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MeSH Terms
Descriptor/Qualifier:
Aged
Body Mass Index
Cohort Studies
Drug Therapy, Combination
Endometrial Neoplasms / epidemiology,  etiology*
Estrogens / adverse effects*
Female
Hormone Replacement Therapy / adverse effects*
Humans
Incidence
Middle Aged
Postmenopause
Progestins / adverse effects*
Chemical
Reg. No./Substance:
0/Estrogens; 0/Progestins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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