Hormone replacement therapy and ovarian cancer risk: A meta-analysis

Zhou, Bo; Sun, Qingmin; Cong, Rihong; Gu, Hongru; Tang, Naping; Yang, Li; Wang, Bin

doi:10.1016/j.ygyno.2007.12.003

Cited by 110 publications

(55 citation statements)

References 69 publications

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“…Similarly, most other individual studies, including the current study, have failed to detect significant differences in risk by HT type, perhaps due to low statistical power. Results from three meta-analyses have shown elevated risks for both estrogenonly and estrogen plus progestin HT, with risk estimates being somewhat higher for estrogen-only preparations, and which is entirely consistent with our findings [1][2][3]. However, a subsequent prospective study from Denmark, and the largest individual study to date, reported a stronger association for estrogen plus progestin therapy (OR, 1.50; 95% CI, 1.34-1.68) than estrogen-only HT (OR, 1.31; 95% CI, 1.11-1.54) compared with never-users [16].…”

Section: Discussionsupporting

confidence: 91%

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Menopausal hormone therapy and risk of ovarian cancer in the European prospective investigation into cancer and nutrition

Tsilidis

Allen

Key

et al. 2011

Cancer Causes Control

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The association between menopausal hormone therapy (HT) and risk of ovarian cancer was assessed among 126,920 post-menopausal women recruited into the European Prospective Investigation into Cancer and Nutrition. After an average of 9-year follow-up, 424 incident ovarian cancers were diagnosed. Cox models adjusted for body mass index, smoking status, unilateral ovariectomy, simple hysterectomy, age at menarche, number of full-term pregnancies, and duration of oral contraceptives were used. Compared with baseline never use, current use of any HT was positively associated with risk (HR [hazard ratio], 1.29; 95% CI [confidence interval], 1.01-1.65), while former use was not (HR, 0.96; 95% CI, 0.70-1.30). Current estrogen-only HT was associated with a 63% higher risk (HR, 1.63; 95% CI, 1.08-2.47), while current estrogen plus progestin was associated with a smaller and non-significant higher risk (HR, 1.20; 95% CI, 0.89-1.62). Use of tibolone was associated with a twofold greater risk (HR, 2.19; 95% CI, 1.06-4.50), but was based on small numbers. In conclusion, women who currently use HT have a moderate increased risk of ovarian cancer, and which may be stronger for estrogen-only than estrogen plus progestin preparations.

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Section: Discussionsupporting

confidence: 91%

“…Use of menopausal hormone therapy (HT) has been associated with an increased risk of ovarian cancer [1][2][3]. However, uncertainty still exists about whether this association varies by specific hormonal constituent, regimen, route of administration, and histological subtype.…”

Section: Introductionmentioning

confidence: 99%

Menopausal hormone therapy and risk of ovarian cancer in the European prospective investigation into cancer and nutrition

Tsilidis

Allen

Key

et al. 2011

Cancer Causes Control

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“…The use of ET may also directly stimulate the growth of premalignant or early malignant cells with longterm use increasing the risk of transformation or proliferation. 32 In addition, the fallopian tube fimbriae, a proposed cell of origin for high-grade serous carcinoma, have been shown to proliferate at times when estrogenic influences are greater during the menstrual cycle, 33 , 34 and this increased activity results in greater cell proliferation which may enhance the risk of mutations and malignant transformation. Estradiol has also been shown to increase ovarian carcinoma cell proliferation in vitro 35 and influence the growth of ovarian tumors in a transplanted mouse model.…”

Section: Discussionmentioning

confidence: 99%

Association Between Menopausal Estrogen-Only Therapy and Ovarian Carcinoma Risk

Lee

Ness

Roman

et al. 2016

Obstetrical &Amp; Gynecological Survey

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Lee et al.Page 2Obstet Gynecol. Author manuscript; available in PMC 2017 May 01. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptObjective-To describe the association between postmenopausal estrogen therapy use and risk of ovarian carcinoma, specifically with regard to disease histotype and duration and timing of use.Methods-We conducted a pooled analysis of 906 women with ovarian carcinoma and 1,220 controls; all 2,126 women included reported having had a hysterectomy. Ten population-based case-control studies participating in the Ovarian Cancer Association Consortium (OCAC), an international consortium whose goal is to combine data from many studies with similar methods so reliable assessments of risk factors can be determined, were included. Self-reported questionnaire data from each study were harmonized and conditional logistic regression was used to examine estrogen therapy's histotype-specific and duration and recency of use associations.Results-Forty-three and a halfpercent of the controls reported previous use of estrogen therapy.Compared to them, current-or-recent estrogen therapy use was associated with an increased risk for the serous (51.4%, OR=1.63, 95% CI 1.27-2.09) and endometrioid (48.6%, OR=2.00, 95% CI 1.17-3.41). In addition, statistically significant trends in risk according to duration of use were seen among current-or-recent postmenopausal estrogen therapy users for both ovarian carcinoma histotypes (p trend <0.001 for serous and endometrioid). Compared to controls, current-or-recent users for ten years or more had increased risks of serous ovarian carcinoma (36.8%, OR=1.73, 95% CI 1.26-2.38) and endometrioid ovarian carcinoma (34.9%, OR=4.03, 95% CI 1.91-8.49).Conclusions-We found evidence of an increased risk of serous and endometriod histiotype ovarian carcinoma associated with postmenopausal estrogen therapy use, particularly of long duration. These findings emphasize that risk may be associated with extended estrogen therapy use.

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“…Consistent with the female genital tract being a target organ of hormones, epidemiological investigations have suggested that malignancies of the genital tract may be associated with hormonal stimuli, and significantly higher risks for breast, endometrial and ovarian epithelium cancer have been observed in post-menopausal women ingesting long-term oral estrogen (8)(9)(10)(11). In vitro experiments have yielded inconsistent results regarding the estrogen stimulation of cancer cell proliferation.…”

Section: Introductionmentioning

confidence: 99%

Impact of post-operative hormone replacement therapy on life quality and prognosis in patients with ovarian malignancy

Pan

Gao

et al. 2011

Oncology Letters

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Abstract. The present study aimed to assess the impact of post-surgical hormone replacement therapy (HRT) on life quality and prognosis in women with ovarian malignancy. HRT (Premarin, Nilestriol and medroxyprogesterone) was administered following surgery in 31 patients with ovarian cancer. A total of 44 ovarian cancer patients of similar age, clinical stage and pathological features did not receive HRT following surgery. The expression of estrogen receptor (ER)-α, ERβ and progesterone receptor (PR) in cancer tissues was detected by immunohistochemical staining. Serum levels of calcitonin (CT) and transforming growth factor (TGF)-α were determined by radioimmunoassay and enzyme-linked immunosorbent assay, respectively. Data were analyzed using Kaplan-Meier survival curves, a log-rank test and a Cox scale risk model. Quality of life was assessed in the patient groups and in healthy post-menopausal women (control) based on a questionnaire developed by the European Organization of Research and Treatment of Cancer (EORTC-C30), as well as our own specific questionnaire. A log-rank test revealed no difference in survival between the patients with and without HRT (p>0.05), and a Cox model showed that HRT was not an independent prognostic factor. The accumulated survival rate did not differ significantly based on the expression of ERα, ERβ or PR in patients with or without HRT (p>0.05). The serum TGFα levels prior to and following surgery were not significantly different in either of the two patient groups (p>0.05). Serum CT levels were higher in patients without HRT at 1.5 years following surgery (p<0.05), but no significant difference was found in the serum CT levels of patients receiving HRT. The HRT and non-HRT groups differed significantly with regard to the body and emotional functional sub-scales of the EORTC-C30 (p<0.05) and the sex quality and autonomic nerve maladjustment categories of our specific questionnaire (p<0.05). Findings of this study showed that HRT administered following surgery exhibited no apparent negative effect on prognosis in patients with ovarian cancer, regardless of ERα, ERβ or PR expression in cancer tissues, and had no effect on serum transforming growth factor (TGF)-α levels. Post-surgical HRT aided in the stabilization of serum CT levels and improved the quality of life in these patients.

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Hormone replacement therapy and ovarian cancer risk: A meta-analysis

Cited by 110 publications

References 69 publications

Menopausal hormone therapy and risk of ovarian cancer in the European prospective investigation into cancer and nutrition

Menopausal hormone therapy and risk of ovarian cancer in the European prospective investigation into cancer and nutrition

Association Between Menopausal Estrogen-Only Therapy and Ovarian Carcinoma Risk

Impact of post-operative hormone replacement therapy on life quality and prognosis in patients with ovarian malignancy

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