Progestins and menopause: epidemiological studies of risks of endometrial and breast cancer

Pike, Malcolm C.; Ross, Ronald K.

doi:10.1016/s0039-128x(00)00122-7

Cited by 103 publications

(71 citation statements)

References 31 publications

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“…Estrogen or progesterone or both are also used in hormonal replacement therapy and are given to women after menopause [18]. However the hormonal replacement therapy has been reported to be associated with increased risk of cancer [19,20]. There are several reports on the genotoxic potential of estrogens and synthetic progestins in vivo and in vitro [21][22][23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Effect of Oral Contraceptive Pills on the Blood Serum Enzymes and DNA Damage in Lymphocytes Among Users

et al. 2015

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The continuous use of synthetic hormones as contraceptive pill or hormonal replacement therapy among women is increasing day by day. The widespread use of different formulations as oral contraceptives by women throughout their reproductive cycle has given rise to a serious concern for studying the effects of oral contraceptives on enzymatic profile and DNA damage in peripheral blood lymphocytes among users. The present study was carried out on women taking oral contraceptives. The study was based on the questionnaire having the information of reproductive history, fasting, age, health, nature of menstrual cycle, bleeding and other disease. The profile of the blood serum enzymes i.e. alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), lactate dehydrogenase (LDH), aminotransferases (SGOT and SGPT), serum proteins (albumin and globulin) and DNA damage in lymphocytes was studied among users and non-users. The results of the present study suggest that OCs not only effects enzymatic activity but also results in DNA damage that may vary with the duration of using oral contraceptives. A significant increase in LDH, GGT, SGPT, SGOT, globulin and decrease in ALP as well as albumin was found among users as compared to non-users. The observed DNA damage was more in users as compared to non-users. Hormonal contraceptives seem to exert DNA damage and also have significant effects on blood serum enzymes.

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Section: Discussionmentioning

confidence: 99%

Effect of Oral Contraceptive Pills on the Blood Serum Enzymes and DNA Damage in Lymphocytes Among Users

et al. 2015

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“…Sequential (i.e., cyclic) regimens traditionally included 5 to 15 days (usually <10 days) of progestin each cycle (5). Progestin exposure for at least 12 or 13 days per cycle is considered necessary to negate increased risks due to estrogens (36). The inclusion of both ''insufficient'' (i.e., <10 days) and ''sufficient'' (i.e., 13-14 days) progestin limits the generalizability of our sequential exposure group.…”

Section: Discussionmentioning

confidence: 99%

“…An extension of this controversial (49) hypothesis could produce positively biased or falsepositive associations between estrogen plus progestin and endometrial carcinoma in observational studies. If belief that continuous estrogen plus progestin does not increase risk (10,36) affects early symptom reporting or delays diagnosis, then more early endometrial carcinomas-lesions that clinical trials might diagnose earlier (i.e., as hyperplasia, not cancer)-would be detected among estrogen plus progestin users in cohort studies. We could not directly test this hypothesis or explore whether it might account for the strength of the estrogen plus progestin associations in our data.…”

Section: Discussionmentioning

confidence: 99%

Endometrial Carcinoma Risks among Menopausal Estrogen plus Progestin and Unopposed Estrogen Users in a Cohort of Postmenopausal Women

Lacey

Brinton

Lubin

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Because unopposed estrogen substantially increases endometrial carcinoma risk, estrogen plus progestin is one menopausal hormone therapy formulation for women who have not had a hysterectomy. However, endometrial carcinoma risks among estrogen plus progestin users and among former unopposed estrogen users are not firmly established. Methods: We evaluated endometrial carcinoma risks associated with estrogen plus progestin and unopposed estrogen therapies in 30,379 postmenopausal Breast Cancer Detection Demonstration Project follow-up study participants. We ascertained hormone therapy use and other risk factors during telephone interviews and mailed questionnaires between 1979 and 1998. We identified 541 endometrial carcinomas via self-report, medical records, the National Death Index, and state cancer registries. Poisson regression generated time-dependent rate ratios (RR) and 95% confidence intervals (95% CI).

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“…Oestrogen alone or different combinations of oestrogen and progestogen are commonly used for reducing the menopausal symptoms among postmenopausal women on hormone replacement therapy (HRT), but are associated with a durationdependent increased risk of endometrial carcinoma (Grady et al 1992(Grady et al , 1995. In addition, others have shown that both progestogen-only contraception and continuous-combined HRT reduce endometrial cancer risk (Vihko & Isomaa 1989, Pike & Ross 2000. The anti-oestrogen tamoxifen (TAM) is the most commonly used treatment for patients with oestrogen receptor (ER)-positive breast cancers.…”

Section: Introductionmentioning

confidence: 99%

The effect of long-term treatment with steroid hormones or tamoxifen on oestrogen receptors (alpha and beta) in the endometrium of ovariectomized cynomolgus macaques

Wang

Isaksson²,

Schoultz³

et al. 2002

Journal of Endocrinology

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The effects of oestrogen are mediated by two specific intracellular receptors, oestrogen receptors (ER) and , which function as ligand-activated transcriptional regulators. Ovariectomized macaques (Macaca fascicularis) were used to study the regulation of ER and ER in the endometrium by immunohistochemistry and in situ hybridization after long-term hormone treatment. Animals were treated continuously for 35 months with either conjugated equine oestrogen (CEE), medroxyprogesterone acetate (MPA), combined CEE/MPA, or tamoxifen (TAM). Treatment with CEE/MPA down-regulated ER in the superficial glands. In the superficial stroma the ER level was lower in the CEE/MPA group than in the CEE and MPA groups. ER immunostaining was faint with minor variation in response to treatment, but increased in the superficial stroma after MPA treatment. The ratio of ER /ER increased in superficial stroma and gland after CEE/MPA treatment, and also in stroma after MPA and TAM. Cystic endometrial hyperplasia was observed in TAM-treated animals, in combination with a high level of ER protein expression. The present data show that long-term hormone treatment affects the ER and ER protein levels in the endometrium. The balance between ER and ER seems to be important for the proliferative response to oestrogen.

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Progestins and menopause: epidemiological studies of risks of endometrial and breast cancer

Cited by 103 publications

References 31 publications

Effect of Oral Contraceptive Pills on the Blood Serum Enzymes and DNA Damage in Lymphocytes Among Users

Effect of Oral Contraceptive Pills on the Blood Serum Enzymes and DNA Damage in Lymphocytes Among Users

Endometrial Carcinoma Risks among Menopausal Estrogen plus Progestin and Unopposed Estrogen Users in a Cohort of Postmenopausal Women

The effect of long-term treatment with steroid hormones or tamoxifen on oestrogen receptors (alpha and beta) in the endometrium of ovariectomized cynomolgus macaques

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