title: Antiestrogen use reduces risk of cervical neoplasia in breast cancer patients: a population-based study.
abstract: Estrogen has been proven to be a necessity for cervical carcinogenesis by transgenic mice studies. To determine whether long-term antiestrogens use could reduce the incidence of cervical neoplasia, a population-based cohort of 42,940 breast cancer patients with and without antiestrogen therapy were identified from the Taiwan National Health Insurance Database. All patients were followed for the most severe form of cervical neoplasia or until death. Their risks of cervical neoplasia were compared with Cox regression analysis and adjusted for age, Pap smear density and chemotherapy. Aromatase inhibitor (AI)-included antiestrogen users consistently exhibited a lower risk of low-grade cervical dysplasia [adjusted hazard ratio (HR) = 0.42, 95% CI 0.29 to 0.64, P < 0.0001] in the five-year follow-up analysis and in subgroup of regular Pap screenings (HR = 0.32, 95% CI, 0.20 to 0.50, P < 0.0001). A lower 10-year incidence of high-grade cervical dysplasia was also noted in the regular-screening group (HR = 0.49; 95% CI, 0.27 to 0.90; P = 0.0212), especially in the ≥ 50 years old group (HR = 0.34; 95% CI, 0.14 to 0.80; P = 0.014). The protection effect of Tamoxifen-only use for low-grade cervical dysplasia was only found in the young-age, regular-screening group (HR = 0.67; 95% CI, 0.48 to 0.93; P = 0.0167).In short, long-term use of AI-included antiestrogen conferred a lower risk of cervical neoplasia.
authors: Department of Public Health, Tzu Chi University, Hualien, Taiwan, ROC.
authors: Chia-Jung
authors: CJ
authors: Hsieh
authors: Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC.|Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, ROC.
authors: Mun-Kun
authors: MK
authors: Hong
authors: Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan, ROC.|Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan, ROC.|Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
authors: Pau-Chung
authors: PC
authors: Chen
authors: Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC.
authors: Jen-Hung
authors: JH
authors: Wang
authors: Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC.|Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, ROC.
authors: Tang-Yuan
authors: TY
authors: Chu
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000209:etiology* / Q000473:pathology; D055815:Young Adult
keywords: antiestrogen; aromatase inhibitor; cervical cancer; cervical neoplasia; tamoxifen