Estrogen plus Progestin Hormone Therapy and Ovarian Cancer: A Complicated Relationship Explored

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Alice W. Lee
  • Anna H. Wu
  • Ashley Wiensch
  • Bhramar Mukherjee
  • Kathryn L. Terry
  • Holly R. Harris
  • Michael E. Carney
  • Allan Jensen
  • Daniel W. Cramer
  • Andrew Berchuck
  • Jennifer Anne Doherty
  • Francesmary Modugno
  • Marc T. Goodman
  • Aliya Alimujiang
  • Mary Anne Rossing
  • Kara L. Cushing-Haugen
  • Elisa V. Bandera
  • Pamela J. Thompson
  • Penelope M. Webb
  • David G. Huntsman
  • Kirstin B. Moysich
  • Galina Lurie
  • Roberta B. Ness
  • Daniel O. Stram
  • Lynda Roman
  • Malcolm C. Pike
  • Celeste Leigh Pearce

Background: Menopausal estrogen-alone therapy is a risk factor for endometrial and ovarian cancers. When a progestin is included with the estrogen daily (continuous estrogen-progestin combined therapy), there is no increased risk of endometrial cancer. However, the effect of continuous estrogen-progestin combined therapy on risk of ovarian cancer is less clear. Methods: We pooled primary data from five population-based case-control studies in the Ovarian Cancer Association Consortium, including 1509 postmenopausal ovarian cancer cases and 2295 postmenopausal controls. Information on previous menopausal hormonal therapy use, as well as ovarian cancer risk factors, was collected using in-person interviews. Logistic regression was used to assess the association between use of continuous estrogen-progestin combined therapy and risk of ovarian cancer by duration and recency of use and disease histotype. Results: Ever postmenopausal use of continuous estrogen-progestin combined therapy was not associated with increased risk of ovarian cancer overall (OR = 0.85, 95% CI = 0.72, 1.0). A decreased risk was observed for mucinous ovarian cancer (OR = 0.40, 95% CI = 0.18, 0.91). The other main ovarian cancer histotypes did not show an association (endometrioid: OR = 0.86, 95% CI = 0.57, 1.3, clear cell: OR = 0.68, 95% CI = 0.40, 1.2; serous: OR = 0.98, 95% CI = 0.80, 1.2). Conclusions: Given that estrogen-alone therapy has been shown to be associated with increased risk of ovarian cancer, these findings are consistent with the hypothesis that adding a progestin each day ameliorates the carcinogenic effects of estrogen on the cells of origin for all histotypes of ovarian cancer.

OriginalsprogEngelsk
TidsskriftEpidemiology
Vol/bind31
Udgave nummer3
Sider (fra-til)402-408
Antal sider7
ISSN1044-3983
DOI
StatusUdgivet - 2020

Bibliografisk note

Funding Information:
The Ovarian Cancer Association Consortium (OCAC) is supported by a grant from the Ovarian Cancer Research Fund and donations by the family and friends of Kathryn Sladek Smith (PPD/RPCI.07). In addi-tion, this work was supported by grants from the National Institutes of Health (R01-CA112523, R01-CA87538, R01-CA58598, N01-CN-55424, N01-PC-67001, R01-CA54419, P50-CA105009, P01-CA17054, P30-CA14089, R01-CA61132, N01-PC67010, R03-CA113148, R03-CA115195, N01-CN025403), the National Cancer Institute (K07-CA080668, R01-CA95023, P50-CA159981, R01-CA61107, K07-CA095666, R01-CA83918, K22-CA138563, and P30-CA072720), the Danish Cancer Society (94 222 52), the Department of Defense (DAMD17-02-1-0669, W81XWH-10-1-02802), the California Cancer Research Program (00-01389V-20170, 2II0200), the Mermaid I Project, and the Cancer Institute of New Jersey. A.W.L. was supported in part by a Scientific Scholar Award from the Rivkin Center for Ovarian Cancer.

Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.

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