Menopausal hormone therapy and risk of endometrial carcinoma among postmenopausal women in the European Prospective Investigation Into Cancer and Nutrition.
Estrogen-only menopausal hormone therapy (HT) increases the risk of endometrial cancer, but less is known about the association with other types of HT. Using Cox proportional hazards regression, the authors examined the association of various types of HT with the risk of endometrial cancer among 115,474 postmenopausal women recruited into the European Prospective Investigation into Cancer and Nutrition between 1992 and 2000. After a mean follow-up period of 9 years, 601 incident cases of endometrial cancer were identified. In comparison with never users of HT, risk of endometrial cancer was increased among current users of estrogen-only HT (hazard ratio (HR) = 2.52, 95% confidence interval (CI): 1.77, 3.57), tibolone (HR = 2.96, 95% CI: 1.67, 5.26), and, to a lesser extent, estrogen-plus-progestin HT (HR = 1.41, 95% CI: 1.08, 1.83), although risks differed according to regimen and type of progestin constituent. The association of HT use with risk was stronger among women who were older, leaner, or had ever smoked cigarettes. The finding of a strong increased risk of endometrial cancer with estrogen-only HT and a weaker association with combined HT supports the hypothesis that progestins have an attenuating effect on endometrial cancer risk. The increased risk associated with tibolone use requires further investigation.
Allen
Naomi E
NE
Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, Medical Sciences Division, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, United Kingdom. naomi.allen@ceu.ox.ac.uk
Tsilidis
Konstantinos K
KK
Key
Timothy J
TJ
Dossus
Laure
L
Kaaks
Rudolf
R
Lund
Eiliv
E
Bakken
Kjersti
K
Gavrilyuk
Oxana
O
Overvad
Kim
K
Tjønneland
Anne
A
Olsen
Anja
A
Fournier
Agnès
A
Fabre
Alban
A
Clavel-Chapelon
Françoise
F
Chabbert-Buffet
Nathalie
N
Sacerdote
Carlotta
C
Krogh
Vittorio
V
Bendinelli
Benedetta
B
Tumino
Rosario
R
Panico
Salvatore
S
Bergmann
Manuela
M
Schuetze
Madlen
M
van Duijnhoven
Fränzel J B
FJ
Bueno-de-Mesquita
H Bas
HB
Onland-Moret
N Charlotte
NC
van Gils
Carla H
CH
Amiano
Pilar
P
Barricarte
Aurelio
A
Chirlaque
Maria-Dolores
MD
Molina-Montes
Maria-Esther
ME
Redondo
María-Luisa
ML
Duell
Eric J
EJ
Khaw
Kay-Tee
KT
Wareham
Nick
N
Rinaldi
Sabina
S
Fedirko
Veronika
V
Mouw
Traci
T
Michaud
Dominique S
DS
Riboli
Elio
E
D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D020847:Estrogen Receptor Modulators; D015914:Estrogen Replacement Therapy; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009652:Norpregnenes; D017698:Postmenopause; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors
D020847:Estrogen Receptor Modulators; D009652:Norpregnenes; C027385:tibolone