title: Menopausal hormone therapy and mortality among women diagnosed with ovarian cancer in the NIH-AARP Diet and Health Study.
abstract: BACKGROUND
  Although menopausal hormone therapy (MHT) use has been linked with an increased risk of ovarian cancer, whether pre-diagnosis MHT use affects ovarian cancer-specific mortality is unknown.
  
  
  METHODS
  Our analysis included 395 incident epithelial ovarian cancer patients with data on pre-diagnosis MHT use from the National Institutes of Health-AARP (NIH-AARP) Diet and Health Study. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for MHT type and ovarian cancer-specific mortality, adjusted for tumor characteristics, treatment, and other risk factors. Effect modification by histology (serous vs. non-serous) was examined using likelihood ratio tests comparing models with and without interaction terms between MHT type and histology.
  
  
  RESULTS
  Ovarian cancer-specific mortality was not associated with pre-diagnosis estrogen-only therapy (ET) (HR = 1.09, 95% CI = 0.70-1.68) or estrogen plus progestin-only therapy (EPT) (HR = 0.97, 95% CI = 0.68-1.38). Neither recency of use nor specific regimen of EPT-only (sequential vs. continuous) was related to mortality. In analyses stratified by histology, no significant association between MHT type and ovarian cancer-specific mortality was observed among serous or non-serous cases; however, a significant interaction between MHT type and histology was noted (p-heterogeneity = 0.01).
  
  
  CONCLUSIONS
  Our results suggest that pre-diagnosis MHT use is not related to risk of ovarian cancer-specific death.
authors.affiliation: Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892-9774, United States ; Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892-9774, United States.
authors.forename: Ashley S
authors.initials: AS
authors.lastname: Felix
authors.affiliation: Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, MD 20889-5600, United States.
authors.forename: Kristen
authors.initials: K
authors.lastname: Bunch
authors.affiliation: Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892-9774, United States.
authors.forename: Hannah P
authors.initials: HP
authors.lastname: Yang
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892-9774, United States.
authors.forename: Hannah
authors.initials: H
authors.lastname: Arem
authors.affiliation: Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892-9774, United States.
authors.forename: Britton
authors.initials: B
authors.lastname: Trabert
authors.affiliation: Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892-9774, United States.
authors.forename: Gretchen L
authors.initials: GL
authors.lastname: Gierach
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892-9774, United States.
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.affiliation: Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, MD 20889-5600, United States.
authors.forename: William J
authors.initials: WJ
authors.lastname: Lowery
authors.affiliation: Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892-9774, United States.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Brinton
keywords: Estrogen plus progestin; Menopausal hormone therapy; Mortality; Ovarian cancer