Menopausal hormone therapy and risk of endometrial carcinoma among postmenopausal women in the european prospective investigation into cancer and nutrition

Naomi E. Allen; Konstantinos K. Tsilidis; Timothy J. Key; Laure Dossus; Rudolf Kaaks; Eiliv Lund; Kjersti Bakken; Oxana Gavrilyuk; Kim Overvad; Anne Tjønneland; Anja Olsen; Agnès Fournier; Alban Fabre; Clavel Chapelon Francxoise; Chabbert Buffet Nathalie; Carlotta Sacerdote; Vittorio Krogh; Benedetta Bendinelli; Rosario Tumino; Salvatore Panico; Manuela Bergmann; Madlen Schuetze; Fränzel J.B.Van Duijnhoven; H. Bueno De Mesquita Bas; N. Onland Moret Charlotte; Carla H.Van Gils; Pilar Amiano; Aurelio Barricarte; Maria Dolores Chirlaque; Maria Esther Molina-Montes; María Luisa Redondo; Eric J. Duell; Kay Tee Khaw; Nick Wareham; Sabina Rinaldi; Veronika Fedirko; Traci Mouw; Dominique S. Michaud; Elio Riboli

doi:10.1093/aje/kwq300

Menopausal hormone therapy and risk of endometrial carcinoma among postmenopausal women in the european prospective investigation into cancer and nutrition

Naomi E. Allen, Konstantinos K. Tsilidis, Timothy J. Key, Laure Dossus, Rudolf Kaaks, Eiliv Lund, Kjersti Bakken, Oxana Gavrilyuk, Kim Overvad, Anne Tjønneland, Anja Olsen, Agnès Fournier, Alban Fabre, Clavel Chapelon Francxoise, Chabbert Buffet Nathalie, Carlotta Sacerdote, Vittorio Krogh, Benedetta Bendinelli, Rosario Tumino, Salvatore PanicoManuela Bergmann, Madlen Schuetze, Fränzel J.B.Van Duijnhoven, H. Bueno De Mesquita Bas, N. Onland Moret Charlotte, Carla H.Van Gils, Pilar Amiano, Aurelio Barricarte, Maria Dolores Chirlaque, Maria Esther Molina-Montes, María Luisa Redondo, Eric J. Duell, Kay Tee Khaw, Nick Wareham, Sabina Rinaldi, Veronika Fedirko, Traci Mouw, Dominique S. Michaud, Elio Riboli

Research output: Contribution to journal › Review article › peer-review

106 Scopus citations

Abstract

Estrogen-only menopausal hormone therapy (HT increases the risk of endometrial cancer, but less is known about the association with other types of HT. Using Cox proportional hazards regression, the authors examined the association of various types of HT with the risk of endometrial cancer among 115,474 postmenopausal women recruited into the European Prospective Investigation into Cancer and Nutrition between 1992 and 2000. After a mean follow-up period of 9 years, 601 incident cases of endometrial cancer were identified. In comparison with never users of HT, risk of endometrial cancer was increased among current users of estrogen-only HT (hazard ratio (HR = 2.52, 95% confidence interval (CI): 1.77, 3.57), tibolone (HR = 2.96, 95% CI: 1.67, 5.26), and, to a lesser extent, estrogen-plus-progestin HT (HR = 1.41, 95% CI: 1.08, 1.83), although risks differed according to regimen and type of progestin constituent. The association of HT use with risk was stronger among women who were older, leaner, or had ever smoked cigarettes. The finding of a strong increased risk of endometrial cancer with estrogenonly HT and a weaker association with combined HT supports the hypothesis that progestins have an attenuating effect on endometrial cancer risk. The increased risk associated with tibolone use requires further investigation.

Original language	English (US)
Pages (from-to)	1394-1403
Number of pages	10
Journal	American journal of epidemiology
Volume	172
Issue number	12
DOIs	https://doi.org/10.1093/aje/kwq300
State	Published - Dec 15 2010

Keywords

Endometrial neoplasms
Estrogen replacement therapy
Norpregnenes
Postmenopause
Prospective studies

ASJC Scopus subject areas

Epidemiology

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10.1093/aje/kwq300

Cite this

Allen, N. E., Tsilidis, K. K., Key, T. J., Dossus, L., Kaaks, R., Lund, E., Bakken, K., Gavrilyuk, O., Overvad, K., Tjønneland, A., Olsen, A., Fournier, A., Fabre, A., Francxoise, C. C., Nathalie, C. B., Sacerdote, C., Krogh, V., Bendinelli, B., Tumino, R., ... Riboli, E. (2010). Menopausal hormone therapy and risk of endometrial carcinoma among postmenopausal women in the european prospective investigation into cancer and nutrition. American journal of epidemiology, 172(12), 1394-1403. https://doi.org/10.1093/aje/kwq300

Menopausal hormone therapy and risk of endometrial carcinoma among postmenopausal women in the european prospective investigation into cancer and nutrition. / Allen, Naomi E.; Tsilidis, Konstantinos K.; Key, Timothy J. et al.
In: American journal of epidemiology, Vol. 172, No. 12, 15.12.2010, p. 1394-1403.

Research output: Contribution to journal › Review article › peer-review

Allen, NE, Tsilidis, KK, Key, TJ, Dossus, L, Kaaks, R, Lund, E, Bakken, K, Gavrilyuk, O, Overvad, K, Tjønneland, A, Olsen, A, Fournier, A, Fabre, A, Francxoise, CC, Nathalie, CB, Sacerdote, C, Krogh, V, Bendinelli, B, Tumino, R, Panico, S, Bergmann, M, Schuetze, M, Duijnhoven, FJBV, Bas, HBDM, Charlotte, NOM, Gils, CHV, Amiano, P, Barricarte, A, Chirlaque, MD, Molina-Montes, ME, Redondo, ML, Duell, EJ, Khaw, KT, Wareham, N, Rinaldi, S, Fedirko, V, Mouw, T, Michaud, DS & Riboli, E 2010, 'Menopausal hormone therapy and risk of endometrial carcinoma among postmenopausal women in the european prospective investigation into cancer and nutrition', American journal of epidemiology, vol. 172, no. 12, pp. 1394-1403. https://doi.org/10.1093/aje/kwq300

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abstract = "Estrogen-only menopausal hormone therapy (HT increases the risk of endometrial cancer, but less is known about the association with other types of HT. Using Cox proportional hazards regression, the authors examined the association of various types of HT with the risk of endometrial cancer among 115,474 postmenopausal women recruited into the European Prospective Investigation into Cancer and Nutrition between 1992 and 2000. After a mean follow-up period of 9 years, 601 incident cases of endometrial cancer were identified. In comparison with never users of HT, risk of endometrial cancer was increased among current users of estrogen-only HT (hazard ratio (HR = 2.52, 95% confidence interval (CI): 1.77, 3.57), tibolone (HR = 2.96, 95% CI: 1.67, 5.26), and, to a lesser extent, estrogen-plus-progestin HT (HR = 1.41, 95% CI: 1.08, 1.83), although risks differed according to regimen and type of progestin constituent. The association of HT use with risk was stronger among women who were older, leaner, or had ever smoked cigarettes. The finding of a strong increased risk of endometrial cancer with estrogenonly HT and a weaker association with combined HT supports the hypothesis that progestins have an attenuating effect on endometrial cancer risk. The increased risk associated with tibolone use requires further investigation.",

keywords = "Endometrial neoplasms, Estrogen replacement therapy, Norpregnenes, Postmenopause, Prospective studies",

author = "Allen, {Naomi E.} and Tsilidis, {Konstantinos K.} and Key, {Timothy J.} and Laure Dossus and Rudolf Kaaks and Eiliv Lund and Kjersti Bakken and Oxana Gavrilyuk and Kim Overvad and Anne Tj{\o}nneland and Anja Olsen and Agn{\`e}s Fournier and Alban Fabre and Francxoise, {Clavel Chapelon} and Nathalie, {Chabbert Buffet} and Carlotta Sacerdote and Vittorio Krogh and Benedetta Bendinelli and Rosario Tumino and Salvatore Panico and Manuela Bergmann and Madlen Schuetze and Duijnhoven, {Fr{\"a}nzel J.B.Van} and Bas, {H. Bueno De Mesquita} and Charlotte, {N. Onland Moret} and Gils, {Carla H.Van} and Pilar Amiano and Aurelio Barricarte and Chirlaque, {Maria Dolores} and Molina-Montes, {Maria Esther} and Redondo, {Mar{\'i}a Luisa} and Duell, {Eric J.} and Khaw, {Kay Tee} and Nick Wareham and Sabina Rinaldi and Veronika Fedirko and Traci Mouw and Michaud, {Dominique S.} and Elio Riboli",

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AU - Allen, Naomi E.

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AU - Key, Timothy J.

AU - Dossus, Laure

AU - Kaaks, Rudolf

AU - Lund, Eiliv

AU - Bakken, Kjersti

AU - Gavrilyuk, Oxana

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Olsen, Anja

AU - Fournier, Agnès

AU - Fabre, Alban

AU - Francxoise, Clavel Chapelon

AU - Nathalie, Chabbert Buffet

AU - Sacerdote, Carlotta

AU - Krogh, Vittorio

AU - Bendinelli, Benedetta

AU - Tumino, Rosario

AU - Panico, Salvatore

AU - Bergmann, Manuela

AU - Schuetze, Madlen

AU - Duijnhoven, Fränzel J.B.Van

AU - Bas, H. Bueno De Mesquita

AU - Charlotte, N. Onland Moret

AU - Gils, Carla H.Van

AU - Amiano, Pilar

AU - Barricarte, Aurelio

AU - Chirlaque, Maria Dolores

AU - Molina-Montes, Maria Esther

AU - Redondo, María Luisa

AU - Duell, Eric J.

AU - Khaw, Kay Tee

AU - Wareham, Nick

AU - Rinaldi, Sabina

AU - Fedirko, Veronika

AU - Mouw, Traci

AU - Michaud, Dominique S.

AU - Riboli, Elio

PY - 2010/12/15

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N2 - Estrogen-only menopausal hormone therapy (HT increases the risk of endometrial cancer, but less is known about the association with other types of HT. Using Cox proportional hazards regression, the authors examined the association of various types of HT with the risk of endometrial cancer among 115,474 postmenopausal women recruited into the European Prospective Investigation into Cancer and Nutrition between 1992 and 2000. After a mean follow-up period of 9 years, 601 incident cases of endometrial cancer were identified. In comparison with never users of HT, risk of endometrial cancer was increased among current users of estrogen-only HT (hazard ratio (HR = 2.52, 95% confidence interval (CI): 1.77, 3.57), tibolone (HR = 2.96, 95% CI: 1.67, 5.26), and, to a lesser extent, estrogen-plus-progestin HT (HR = 1.41, 95% CI: 1.08, 1.83), although risks differed according to regimen and type of progestin constituent. The association of HT use with risk was stronger among women who were older, leaner, or had ever smoked cigarettes. The finding of a strong increased risk of endometrial cancer with estrogenonly HT and a weaker association with combined HT supports the hypothesis that progestins have an attenuating effect on endometrial cancer risk. The increased risk associated with tibolone use requires further investigation.

AB - Estrogen-only menopausal hormone therapy (HT increases the risk of endometrial cancer, but less is known about the association with other types of HT. Using Cox proportional hazards regression, the authors examined the association of various types of HT with the risk of endometrial cancer among 115,474 postmenopausal women recruited into the European Prospective Investigation into Cancer and Nutrition between 1992 and 2000. After a mean follow-up period of 9 years, 601 incident cases of endometrial cancer were identified. In comparison with never users of HT, risk of endometrial cancer was increased among current users of estrogen-only HT (hazard ratio (HR = 2.52, 95% confidence interval (CI): 1.77, 3.57), tibolone (HR = 2.96, 95% CI: 1.67, 5.26), and, to a lesser extent, estrogen-plus-progestin HT (HR = 1.41, 95% CI: 1.08, 1.83), although risks differed according to regimen and type of progestin constituent. The association of HT use with risk was stronger among women who were older, leaner, or had ever smoked cigarettes. The finding of a strong increased risk of endometrial cancer with estrogenonly HT and a weaker association with combined HT supports the hypothesis that progestins have an attenuating effect on endometrial cancer risk. The increased risk associated with tibolone use requires further investigation.

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KW - Estrogen replacement therapy

KW - Norpregnenes

KW - Postmenopause

KW - Prospective studies

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Menopausal hormone therapy and risk of endometrial carcinoma among postmenopausal women in the european prospective investigation into cancer and nutrition

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