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.
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
Naomi E
NE
Allen
Konstantinos K
KK
Tsilidis
Timothy J
TJ
Key
Laure
L
Dossus
Rudolf
R
Kaaks
Eiliv
E
Lund
Kjersti
K
Bakken
Oxana
O
Gavrilyuk
Kim
K
Overvad
Anne
A
Tjønneland
Anja
A
Olsen
Agnès
A
Fournier
Alban
A
Fabre
Françoise
F
Clavel-Chapelon
Nathalie
N
Chabbert-Buffet
Carlotta
C
Sacerdote
Vittorio
V
Krogh
Benedetta
B
Bendinelli
Rosario
R
Tumino
Salvatore
S
Panico
Manuela
M
Bergmann
Madlen
M
Schuetze
Fränzel J B
FJ
van Duijnhoven
H Bas
HB
Bueno-de-Mesquita
N Charlotte
NC
Onland-Moret
Carla H
CH
van Gils
Pilar
P
Amiano
Aurelio
A
Barricarte
Maria-Dolores
MD
Chirlaque
Maria-Esther
ME
Molina-Montes
María-Luisa
ML
Redondo
Eric J
EJ
Duell
Kay-Tee
KT
Khaw
Nick
N
Wareham
Sabina
S
Rinaldi
Veronika
V
Fedirko
Traci
T
Mouw
Dominique S
DS
Michaud
Elio
E
Riboli
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