Hormone Replacement Therapy and the Risk of Invasive Epithelial Ovarian Cancer in Swedish Women

Riman, Tomas; Dickman, Paul W.; Nilsson, Staffan; Correia, N.; Nordlinder, Hans; Magnusson, Cecilia; Weiderpass, Elisabete; Persson, Ingemar

doi:10.1093/jnci/94.7.497

Cited by 212 publications

(178 citation statements)

References 55 publications

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“…In contrast, several studies published since this metaanalysis have suggested that long-term use of E-alone may increase risk [5,7,15,29,30]. In a cohort study, Lacey et al detected a significantly increased risk of ovarian cancer in women who had used estrogen therapy for 10-19 years (HR=1.8, 95% CI: 1.1-3.0) or more than 20 years (HR=3.2, 95% CI: 1.7-5.7) compared to never users [15].…”

Section: Discussionmentioning

confidence: 67%

“…Results from studies conducted in the U.S. [5,11,[13][14][15]31,32], Australia [33], Norway [8], Sweden [29], and U.K [7] have been inconclusive regarding the relationship between EP and ovarian cancer. Overall, we detected no associations with EP use.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, we detected no associations with EP use. Likewise, many observational studies have not supported an association [5,11,15,29,31,33]. Two large cohort studies and one randomized controlled trial have suggested an increased risk of 50% in association with EP use [8,13,14].…”

Section: Discussionmentioning

confidence: 99%

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Hormone therapy and ovarian cancer: incidence and survival

Wernli

Newcomb

Hampton

et al. 2008

Cancer Causes Control

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Objective-We conducted a population-based case-control study to investigate the association between hormone therapy (HT) and ovarian cancer incidence, and followed all these cancer cases to determine the association of HT use with ovarian cancer mortality.Methods-Seven hundred fifty-one incident cases of invasive epithelial ovarian cancer aged 40-79 years were diagnosed in Wisconsin and Massachusetts between 1993-1995 and matched to similarly-aged controls (n=5808). Study subjects were interviewed by telephone, which ascertained information on HT use and specific preparation, estrogen alone (E-alone) or estrogen plus progestin (EP). Ovarian cancer cases were followed-up for mortality through December 2005. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals (CI) for ovarian cancer incidence, and Cox proportional hazards modeling was used to estimate hazard ratios and corresponding confidence intervals for ovarian cancer mortality.Results-Ever use of HT was significantly associated with an increased risk of ovarian cancer (odds ratio 1.57, 95% CI 1.31-1.87). The excess risk was confined to women who used E-alone preparations (OR 2.33, 95% CI 1.85-2.95). No significant associations were detected between pre-diagnosis HT use and ovarian cancer survival.Conclusions-Hormone therapy increases risk of ovarian cancer among E-alone users, but there is no substantial impact on survival after diagnosis.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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Hormone therapy and ovarian cancer: incidence and survival

Wernli

Newcomb

Hampton

et al. 2008

Cancer Causes Control

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“…Meta-analyses (Garg et al, 1998;Coughlin et al, 2000) and certain case -control studies (Weiss et al, 1982;Riman et al, 2002) also failed to find a significant trend with duration of use, although some found a positive association (Risch, 1996) or suggested a positive trend (Kaufman et al, 1989;Bosetti et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, unopposed estrogen use has been positively associated with ovarian cancer risk or mortality in several cohort studies (Rodriguez et al, 2001;Lacey et al, 2002Lacey et al, , 2006Folsom et al, 2004). Although estrogen plus progestin use also has been examined in multiple studies (Lacey et al, 2002(Lacey et al, , 2006Riman et al, 2002;Sit et al, 2002), only one cohort study reported a substantial number of cases among long-duration estrogen plus progestin users, finding a significant increased risk of ovarian cancer (Lacey et al, 2006).…”

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confidence: 99%

A prospective study of postmenopausal hormone use and ovarian cancer risk

et al. 2006

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The relationship between postmenopausal hormone use (PMH) and ovarian cancer risk is unclear, particularly for specific hormone formulations, but recent studies suggest that there is a positive association. We conducted a prospective observational study with 82 905 postmenopausal women, including 389 ovarian cancers, in the Nurses' Health Study from 1976 to 2002. Compared with never users of PMH, both current and past users of X5 years had a significantly elevated risk of ovarian cancer (RR ¼ 1.41, 95% confidence interval (CI) 1.07 -1.86 and relative risk (RR) ¼ 1.52, 95% CI 1.01 -2.27, respectively). Examined by hormone type in continuous years, use of unopposed estrogen was associated with a significant increase in the risk of epithelial ovarian cancer (P for trend o0.001; RR for 5-year increment of use ¼ 1.25, 95% CI 1.12 -1.38). Use of estrogen plus progestin (RR for 5-year increment of use ¼ 1.04, 95% CI 0.82 -1.32) was not significantly associated with ovarian cancer risk. Generally, results were similar for serous tumours (RR for 5-year increment of unopposed estrogen use ¼ 1.23, 95% CI 1.07 -1.40) and slightly stronger for endometrioid tumours (RR for 5-year increment of unopposed estrogen use ¼ 1.53, 95% CI 1.20 -1.94). Recency of use was not significantly associated with ovarian cancer risk, but statistical power was limited here.

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