title: Postmenopausal hormone therapy-also use of estradiol plus levonorgestrel-intrauterine system is associated with an increased risk of primary fallopian tube carcinoma.
abstract: Data on the possible impact of postmenopausal hormone therapy (HT) on the incidence of rare primary fallopian tube carcinoma (PFTC) are scarce. Therefore, we conducted a nationwide case-control study analyzing the association between the use of different HTs and PFTC. All women aged 50 years or older with an incident PFTC (n = 360) during 1995-2007 were identified from the Finnish Cancer Registry. For each case of PFTC, ten age- and place of residence-matched controls were selected from the Finnish National Population Register, which also provided information on parity. Data on HT purchases were received from the Prescription Register, and data on hysterectomies and sterilizations from the National Care Register. Controls with a salpingectomy before the PFTC diagnosis of the respective case were excluded. The PFTC risk in relation to different HTs was estimated with a conditional logistic regression model, adjusted for parity, age at last delivery, hysterectomy and sterilization. The use for five years or more of estradiol combined with levonorgestrel-releasing-intrauterine system (odds ratio 2.84, 95% confidence interval 1.10-7.38) and sequential estradiol-progestin therapy (EPT; 3.37; 2.23-5.08) were both linked with increases in the risk of PFTC, while the risk with use of estradiol-only therapy or continuous EPT was not statistically significantly increased. The OR for the use of tibolone for one year or more was 1.56 (0.55-4.41). The use of HT is related to an increased risk of PFTC, particularly when a progestin component is intrauterine or systemic progestin is given in sequential manner.
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Hospital, FI-00029 HUS, Finland.
authors.forename: Virpi
authors.initials: V
authors.lastname: Koskela-Niska
authors.affiliation: Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Unioninkatu 20, Helsinki, FI-00130, Finland.|School of Health Sciences, FI-33014 University of Tampere, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Pukkala
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Hospital, FI-00029 HUS, Finland.
authors.forename: Heli
authors.initials: H
authors.lastname: Lyytinen
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Hospital, FI-00029 HUS, Finland.
authors.forename: Olavi
authors.initials: O
authors.lastname: Ylikorkala
authors.affiliation: Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Unioninkatu 20, Helsinki, FI-00130, Finland.|Public Health-Cancer Policy Support, European Commission DG Joint Research Centre, Institute for Health and Consumer Protection, Ispra, I-21027, Italy.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Dyba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004359:Drug Therapy, Combination / Q000009:adverse effects; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005185:Fallopian Tube Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage / Q000009:adverse effects*; D016015:Logistic Models; D008875:Middle Aged; D017698:Postmenopause; D012307:Risk Factors
chemical_list: D004958:Estradiol; D016912:Levonorgestrel
keywords: estrogen; hysterectomy; levonorgestrel intrauterine system; parity; progestin; sterilization; tibolone