Menopausal Hormone Therapy and Risk of Endometrial Carcinoma Among Postmenopausal Women in the European Prospective Investigation into Cancer and Nutrition

• Published in: American journal of epidemiology 2010-12, Vol.172 (12), p.1394-1403
• Main Authors: Allen, Naomi E., Tsilidis, Konstantinos K., Key, Timothy J., Dossus, Laure, Kaaks, Rudolf, Lund, Eiliv, Bakken, Kjersti, Gavrilyuk, Oxana, Overvad, Kim, Tjønneland, Anne, Olsen, Anja, Fournier, Agnès, Fabre, Alban, Clavel-Chapelon, Françoise, Chabbert-Buffet, Nathalie, Sacerdote, Carlotta, Krogh, Vittorio, Bendinelli, Benedetta, Tumino, Rosario, Panico, Salvatore, Bergmann, Manuela, Schuetze, Madlen, van Duijnhoven, Fränzel J. B., Bas Bueno-de-Mesquita, H., Charlotte Onland-Moret, N., van Gils, Carla H., Amiano, Pilar, Barricarte, Aurelio, Chirlaque, Maria-Dolores, Molina-Montes, Maria-Esther, Redondo, María-Luisa, Duell, Eric J., Khaw, Kay-Tee, Wareham, Nick, Rinaldi, Sabina, Fedirko, Veronika, Mouw, Traci, Michaud, Dominique S., Riboli, Elio
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Biological and medical sciences; Body Mass Index; Cohort Studies; Endocrine therapy; Endometrial cancer; endometrial neoplasms; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - epidemiology; Epidemiology; Estrogen Receptor Modulators; Estrogen Replacement Therapy; Europe - epidemiology; Female; Female genital diseases; General aspects; Gynecology. Andrology. Obstetrics; Hormones; Humans; Incidence; Medical sciences; Menopause; Metabolic diseases; Middle Aged; Miscellaneous; Norpregnenes; Postmenopause; Proportional Hazards Models; prospective studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Risk Factors; Tumors; Womens health
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwq300

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 estrogen-only 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.