Hormonal contraceptive use and risk of glioma among younger women: a nationwide case–control study

Andersen, Lene; Friis, Søren; Hallas, Jesper; Ravn, Pernille; Kristensen, Bjarne Winther; Garcı́a-Dorado, David

doi:10.1111/bcp.12535

Cited by 20 publications

(17 citation statements)

References 34 publications

(48 reference statements)

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“…Findings of an increased risk of CNS tumors related to use of menopausal hormone therapy ( Benson et al , 2010 ; Andersen et al , 2013 ) have prompted an interest in the role of other exogenous hormones. In line with this, a recent study from Denmark found an association between glioma and the use of oral contraceptives, with a nearly 2-fold increase in risk ( Andersen et al , 2015 ). Estrogen has been shown to exert a protective effect on glial cells in vitro ( Shy et al , 2000 ), and it could be that infertile women, or some subgroups thereof, harbor an altered steroid hormone profile, in some way associated with elevated risk of CNS tumors.…”

Section: Discussionmentioning

confidence: 56%

Cancer risk among parous women following assisted reproductive technology

et al. 2015

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STUDY QUESTIONDo women who give birth after assisted reproductive technology (ART) have an increased risk of cancer compared with women who give birth without ART?SUMMARY ANSWERWithout correction, the results indicate an increase in overall cancer risk, as well as a 50% increase in risk of CNS cancer for women giving birth after ART, however the results were not significant after correcting for multiple analyses.WHAT IS KNOWN ALREADYStudies regarding the effects of hormonal treatments involved with ART on subsequent cancer risk have provided inconsistent results, and it has also been suggested that infertility itself could be a contributory factor.STUDY DESIGN, SIZE, DURATIONA population-based cohort consisting of all women registered in the Medical Birth Registry of Norway as having given birth between 1 January 1984 and 31 December 2010 was assembled (n = 812 986). Cancers were identified by linkage to the Cancer Registry of Norway. Study subjects were followed from start of first pregnancy during the observational period until the first cancer, death, emigration, or 31 December 2010.PARTICIPANTS/MATERIALS, SETTING, METHODSOf the total study population (n = 806 248), 16 525 gave birth to a child following ART. Cox regression analysis computed hazard ratios (HR) and 95% confidence intervals (CI) comparing cancer risk between ART women and non-ART women; for overall cancer, and for cervical, ovarian, uterine, central nervous system (CNS), colorectal and thyroid cancers, and for malignant melanoma.MAIN RESULTS AND THE ROLE OF CHANCEA total of 22 282 cohort members were diagnosed with cancer, of which 338 were ART women and 21 944 non-ART women. The results showed an elevated risk in one out of seven sites for ART women. The HR for cancer of the CNS was 1.50 (95% CI 1.03– 2.18), and among those specifically subjected to IVF (without ICSI) the HR was 1.83 (95% CI 1.22–2.73). Analysis of risk of overall cancer gave an HR of 1.16 (95% CI 1.04–1.29). Among those who had delivered only one child by the end of follow-up, the HR for ovarian cancer was 2.00 (95% CI 1.08–3.65), and for those nulliparous at entry the HR was 1.80 (95% CI 1.04–3.11). However, all findings became non-significant after correcting for multiple analyses.LIMITATIONS, REASONS FOR CAUTIONThe results of elevated risk of overall cancer and CNS cancer lost significance when adjusting for multiple analyses, implying an important limitation of the study. The follow-up time was relatively short, especially for ART women. In addition, as the cohort was relatively young, there were few incident cancers, especially for some rarer cancer forms, such as uterine cancer. Risk assessments according to different causes of infertility could not be done.WIDER IMPLICATIONS OF THE FINDINGSIn light of the findings in the present study, further studies should be made on risk of CNS and ovarian cancer, and continued monitoring of all those treated with ART is encouraged. Our findings may only be generalizable to women who give birth after ART, and the risk for women who r...

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Section: Discussionmentioning

confidence: 56%

Cancer risk among parous women following assisted reproductive technology

et al. 2015

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“…A case-control study was conducted on pre-menopausal women including 317 cases for 2126 controls in order to study the impact of contraceptive pill intake on the risk of developing glioma. The odds ratio (OR) for progestogen contraceptives alone is 2.8 which is higher than the combination of estrogen and progestogen pills (OR 1.4) [55]. The presence of estrogens in certain types of pill seemed to reduce the negative impact of progestin alone on glioma risk.…”

Section: Contraceptive Pills and Hormone Replacement Therapy: The Twomentioning

confidence: 96%

Astrocytoma: A Hormone-Sensitive Tumor?

Hirtz

Rech

Dubois-Pot-Schneider

et al. 2020

IJMS

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Astrocytomas and, in particular, their most severe form, glioblastoma, are the most aggressive primary brain tumors and those with the poorest vital prognosis. Standard treatment only slightly improves patient survival. Therefore, new therapies are needed. Very few risk factors have been clearly identified but many epidemiological studies have reported a higher incidence in men than women with a sex ratio of 1:4. Based on these observations, it has been proposed that the neurosteroids and especially the estrogens found in higher concentrations in women’s brains could, in part, explain this difference. Estrogens can bind to nuclear or membrane receptors and potentially stimulate many different interconnected signaling pathways. The study of these receptors is even more complex since many isoforms are produced from each estrogen receptor encoding gene through alternative promoter usage or splicing, with each of them potentially having a specific role in the cell. The purpose of this review is to discuss recent data supporting the involvement of steroids during gliomagenesis and to focus on the potential neuroprotective role as well as the mechanisms of action of estrogens in gliomas.

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“…However, another study conducted by Andersen and cols showed that the use of hormonal contraceptives for an extended period increases glioma risk. This study was performed using Denmark’s national administrative and health registries with 317 glioma cases and 2126 controls [ 96 ]. Most recently, in 2018, a meta-analysis of case-control and cohort studies showed that a decreased risk of gliomas is associated with the use of hormonal contraceptives and hormone replacement therapy.…”

Section: Glioblastomamentioning

confidence: 99%

Impact of sex in the prevalence and progression of glioblastomas: the role of gonadal steroid hormones

Bello-Álvarez

2021

Biol Sex Differ

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Background As in other types of cancers, sex is an essential factor in the origin and progression of glioblastomas. Research in the field of endocrinology and cancer suggests that gonadal steroid hormones play an important role in the progression and prevalence of glioblastomas. In the present review, we aim to discuss the actions and mechanism triggered by gonadal steroid hormones in glioblastomas. Main body Glioblastoma is the most common malignant primary brain tumor. According to the epidemiological data, glioblastomas are more frequent in men than in women in a 1.6/1 proportion both in children and adults. This evidence, and the knowledge about sex influence over the prevalence of countless diseases, suggest that male gonadal steroid hormones, such as testosterone, promote glioblastomas growth. In contrast, a protective role of female gonadal steroid hormones (estradiol and progesterone) against glioblastomas has been questioned. Several pieces of evidence demonstrate a variety of effects induced by female and male gonadal steroid hormones in glioblastomas. Several studies indicate that pregnancy, a physiological state with the highest progesterone and estradiol levels, accelerates the progression of low-grade astrocytomas to glioblastomas and increases the symptoms associated with these tumors. In vitro studies have demonstrated that progesterone has a dual role in glioblastoma cells: physiological concentrations promote cell proliferation, migration, and invasion while very high doses (out physiological range) reduce cell proliferation and increases cell death. Conclusion Gonadal steroid hormones can stimulate the progression of glioblastomas through the increase in proliferation, migration, and invasion. However, the effects mentioned above depend on the concentrations of these hormones and the receptor involved in hormone actions. Estradiol and progesterone can exert promoter or protective effects while the role of testosterone has been always associated to glioblastomas progression.

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Hormonal contraceptive use and risk of glioma among younger women: a nationwide case–control study

Cited by 20 publications

References 34 publications

Cancer risk among parous women following assisted reproductive technology

Cancer risk among parous women following assisted reproductive technology

Astrocytoma: A Hormone-Sensitive Tumor?

Impact of sex in the prevalence and progression of glioblastomas: the role of gonadal steroid hormones

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