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 journalReview article

    79 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 languageEnglish (US)
    Pages (from-to)1394-1403
    Number of pages10
    JournalAmerican journal of epidemiology
    Volume172
    Issue number12
    DOIs
    StatePublished - Dec 15 2010

    Keywords

    • Endometrial neoplasms
    • Estrogen replacement therapy
    • Norpregnenes
    • Postmenopause
    • Prospective studies

    ASJC Scopus subject areas

    • Epidemiology

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  • 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