Menopausal hormone replacement therapy and risk of ovarian cancer

James V. Lacey, Pamela J. Mink, Jay H. Lubin, Mark E. Sherman, Rebecca Troisi, Patricia Hartge, Arthur Schatzkin, Catherine Schairer

Research output: Contribution to journalArticle

511 Citations (Scopus)

Abstract

Context: The association between menopausal hormone replacement therapy and ovarian cancer is unclear. Objective: To determine whether hormone replacement therapy using estrogen only, estrogen-progestin only, or both estrogen only and estrogen-progestin increases ovarian cancer risk. Design A 1979-1998 cohort study of former participants in the Breast Cancer Detection Demonstration Project, a nationwide breast cancer screening program. Setting Twenty-nine US clinical centers. Participants A total of 44241 postmenopausal women (mean age at start of follow-up, 56.6 years). Main Outcome Measure Incident ovarian cancer. Results: We identified 329 women who developed ovarian cancer during follow-up. In time-dependent analyses adjusted for age, menopause type, and oral contraceptive use, ever use of estrogen only was significantly associated with ovarian cancer (rate ratio [RR], 1.6; 95% confidence interval [CI], 1.2-2.0). Increasing duration of estrogen-only use was significantly associated with ovarian cancer: RRs for 10 to 19 years and 20 or more years were 1.8 (95% CI, 1.1-3.0) and 3.2 (95% CI, 1.7-5.7), respectively (P value for trend <.001), and we observed a 7% (95% CI, 2%-13%) increase in RR per year of use. We observed significantly elevated RRs with increasing duration of estrogen-only use across all strata of other ovarian cancer risk factors, including women with hysterectomy. The RR for estrogen-progestin use after prior estrogen-only use was 1.5 (95% CI, 0.91-2.4), but the RR for estrogen-progestin-only use was 1.1 (95% CI, 0.64-1.7). The RRs for less than 2 years and 2 or more years of estrogen-progestin-only use were 1.6 (95% CI, 0.78-3.3) and 0.80 (95% CI, 0.35-1.8), respectively, and there was no evidence of a duration response (P value for trend=.30). Conclusion: Women who used estrogen-only replacement therapy, particularly for 10 or more years, were at significantly increased risk of ovarian cancer in this study. Women who used short-term estrogen -progestin-only replacement therapy were not at increased risk, but risk associated with short-term and longer-term estrogen-progestin replacement therapy warrants further investigation.

Original languageEnglish (US)
Pages (from-to)334-341
Number of pages8
JournalJournal of the American Medical Association
Volume288
Issue number3
StatePublished - Jul 17 2002

Fingerprint

Hormone Replacement Therapy
Ovarian Neoplasms
Estrogens
Confidence Intervals
Progestins
Estrogen Replacement Therapy
Breast Neoplasms
Oral Contraceptives
Menopause
Hysterectomy
Early Detection of Cancer
Cohort Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Lacey, J. V., Mink, P. J., Lubin, J. H., Sherman, M. E., Troisi, R., Hartge, P., ... Schairer, C. (2002). Menopausal hormone replacement therapy and risk of ovarian cancer. Journal of the American Medical Association, 288(3), 334-341.

Menopausal hormone replacement therapy and risk of ovarian cancer. / Lacey, James V.; Mink, Pamela J.; Lubin, Jay H.; Sherman, Mark E.; Troisi, Rebecca; Hartge, Patricia; Schatzkin, Arthur; Schairer, Catherine.

In: Journal of the American Medical Association, Vol. 288, No. 3, 17.07.2002, p. 334-341.

Research output: Contribution to journalArticle

Lacey, JV, Mink, PJ, Lubin, JH, Sherman, ME, Troisi, R, Hartge, P, Schatzkin, A & Schairer, C 2002, 'Menopausal hormone replacement therapy and risk of ovarian cancer', Journal of the American Medical Association, vol. 288, no. 3, pp. 334-341.
Lacey JV, Mink PJ, Lubin JH, Sherman ME, Troisi R, Hartge P et al. Menopausal hormone replacement therapy and risk of ovarian cancer. Journal of the American Medical Association. 2002 Jul 17;288(3):334-341.
Lacey, James V. ; Mink, Pamela J. ; Lubin, Jay H. ; Sherman, Mark E. ; Troisi, Rebecca ; Hartge, Patricia ; Schatzkin, Arthur ; Schairer, Catherine. / Menopausal hormone replacement therapy and risk of ovarian cancer. In: Journal of the American Medical Association. 2002 ; Vol. 288, No. 3. pp. 334-341.
@article{5c10510af2804b5ca3e16f7819292c4a,
title = "Menopausal hormone replacement therapy and risk of ovarian cancer",
abstract = "Context: The association between menopausal hormone replacement therapy and ovarian cancer is unclear. Objective: To determine whether hormone replacement therapy using estrogen only, estrogen-progestin only, or both estrogen only and estrogen-progestin increases ovarian cancer risk. Design A 1979-1998 cohort study of former participants in the Breast Cancer Detection Demonstration Project, a nationwide breast cancer screening program. Setting Twenty-nine US clinical centers. Participants A total of 44241 postmenopausal women (mean age at start of follow-up, 56.6 years). Main Outcome Measure Incident ovarian cancer. Results: We identified 329 women who developed ovarian cancer during follow-up. In time-dependent analyses adjusted for age, menopause type, and oral contraceptive use, ever use of estrogen only was significantly associated with ovarian cancer (rate ratio [RR], 1.6; 95{\%} confidence interval [CI], 1.2-2.0). Increasing duration of estrogen-only use was significantly associated with ovarian cancer: RRs for 10 to 19 years and 20 or more years were 1.8 (95{\%} CI, 1.1-3.0) and 3.2 (95{\%} CI, 1.7-5.7), respectively (P value for trend <.001), and we observed a 7{\%} (95{\%} CI, 2{\%}-13{\%}) increase in RR per year of use. We observed significantly elevated RRs with increasing duration of estrogen-only use across all strata of other ovarian cancer risk factors, including women with hysterectomy. The RR for estrogen-progestin use after prior estrogen-only use was 1.5 (95{\%} CI, 0.91-2.4), but the RR for estrogen-progestin-only use was 1.1 (95{\%} CI, 0.64-1.7). The RRs for less than 2 years and 2 or more years of estrogen-progestin-only use were 1.6 (95{\%} CI, 0.78-3.3) and 0.80 (95{\%} CI, 0.35-1.8), respectively, and there was no evidence of a duration response (P value for trend=.30). Conclusion: Women who used estrogen-only replacement therapy, particularly for 10 or more years, were at significantly increased risk of ovarian cancer in this study. Women who used short-term estrogen -progestin-only replacement therapy were not at increased risk, but risk associated with short-term and longer-term estrogen-progestin replacement therapy warrants further investigation.",
author = "Lacey, {James V.} and Mink, {Pamela J.} and Lubin, {Jay H.} and Sherman, {Mark E.} and Rebecca Troisi and Patricia Hartge and Arthur Schatzkin and Catherine Schairer",
year = "2002",
month = "7",
day = "17",
language = "English (US)",
volume = "288",
pages = "334--341",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "3",

}

TY - JOUR

T1 - Menopausal hormone replacement therapy and risk of ovarian cancer

AU - Lacey, James V.

AU - Mink, Pamela J.

AU - Lubin, Jay H.

AU - Sherman, Mark E.

AU - Troisi, Rebecca

AU - Hartge, Patricia

AU - Schatzkin, Arthur

AU - Schairer, Catherine

PY - 2002/7/17

Y1 - 2002/7/17

N2 - Context: The association between menopausal hormone replacement therapy and ovarian cancer is unclear. Objective: To determine whether hormone replacement therapy using estrogen only, estrogen-progestin only, or both estrogen only and estrogen-progestin increases ovarian cancer risk. Design A 1979-1998 cohort study of former participants in the Breast Cancer Detection Demonstration Project, a nationwide breast cancer screening program. Setting Twenty-nine US clinical centers. Participants A total of 44241 postmenopausal women (mean age at start of follow-up, 56.6 years). Main Outcome Measure Incident ovarian cancer. Results: We identified 329 women who developed ovarian cancer during follow-up. In time-dependent analyses adjusted for age, menopause type, and oral contraceptive use, ever use of estrogen only was significantly associated with ovarian cancer (rate ratio [RR], 1.6; 95% confidence interval [CI], 1.2-2.0). Increasing duration of estrogen-only use was significantly associated with ovarian cancer: RRs for 10 to 19 years and 20 or more years were 1.8 (95% CI, 1.1-3.0) and 3.2 (95% CI, 1.7-5.7), respectively (P value for trend <.001), and we observed a 7% (95% CI, 2%-13%) increase in RR per year of use. We observed significantly elevated RRs with increasing duration of estrogen-only use across all strata of other ovarian cancer risk factors, including women with hysterectomy. The RR for estrogen-progestin use after prior estrogen-only use was 1.5 (95% CI, 0.91-2.4), but the RR for estrogen-progestin-only use was 1.1 (95% CI, 0.64-1.7). The RRs for less than 2 years and 2 or more years of estrogen-progestin-only use were 1.6 (95% CI, 0.78-3.3) and 0.80 (95% CI, 0.35-1.8), respectively, and there was no evidence of a duration response (P value for trend=.30). Conclusion: Women who used estrogen-only replacement therapy, particularly for 10 or more years, were at significantly increased risk of ovarian cancer in this study. Women who used short-term estrogen -progestin-only replacement therapy were not at increased risk, but risk associated with short-term and longer-term estrogen-progestin replacement therapy warrants further investigation.

AB - Context: The association between menopausal hormone replacement therapy and ovarian cancer is unclear. Objective: To determine whether hormone replacement therapy using estrogen only, estrogen-progestin only, or both estrogen only and estrogen-progestin increases ovarian cancer risk. Design A 1979-1998 cohort study of former participants in the Breast Cancer Detection Demonstration Project, a nationwide breast cancer screening program. Setting Twenty-nine US clinical centers. Participants A total of 44241 postmenopausal women (mean age at start of follow-up, 56.6 years). Main Outcome Measure Incident ovarian cancer. Results: We identified 329 women who developed ovarian cancer during follow-up. In time-dependent analyses adjusted for age, menopause type, and oral contraceptive use, ever use of estrogen only was significantly associated with ovarian cancer (rate ratio [RR], 1.6; 95% confidence interval [CI], 1.2-2.0). Increasing duration of estrogen-only use was significantly associated with ovarian cancer: RRs for 10 to 19 years and 20 or more years were 1.8 (95% CI, 1.1-3.0) and 3.2 (95% CI, 1.7-5.7), respectively (P value for trend <.001), and we observed a 7% (95% CI, 2%-13%) increase in RR per year of use. We observed significantly elevated RRs with increasing duration of estrogen-only use across all strata of other ovarian cancer risk factors, including women with hysterectomy. The RR for estrogen-progestin use after prior estrogen-only use was 1.5 (95% CI, 0.91-2.4), but the RR for estrogen-progestin-only use was 1.1 (95% CI, 0.64-1.7). The RRs for less than 2 years and 2 or more years of estrogen-progestin-only use were 1.6 (95% CI, 0.78-3.3) and 0.80 (95% CI, 0.35-1.8), respectively, and there was no evidence of a duration response (P value for trend=.30). Conclusion: Women who used estrogen-only replacement therapy, particularly for 10 or more years, were at significantly increased risk of ovarian cancer in this study. Women who used short-term estrogen -progestin-only replacement therapy were not at increased risk, but risk associated with short-term and longer-term estrogen-progestin replacement therapy warrants further investigation.

UR - http://www.scopus.com/inward/record.url?scp=0037125454&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037125454&partnerID=8YFLogxK

M3 - Article

C2 - 12117398

AN - SCOPUS:0037125454

VL - 288

SP - 334

EP - 341

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 3

ER -