Estrogen Plus Progestin Hormone Therapy and Ovarian Cancer: A Complicated Relationship Explored

Alice W Lee; Anna H Wu; Ashley Wiensch; Bhramar Mukherjee; Kathryn L Terry; Holly R Harris; Michael E Carney; Allan Jensen; Daniel W Cramer; Andrew Berchuck; Jennifer Anne Doherty; Francesmary Modugno; Marc T Goodman; Aliya Alimujiang; Mary Anne Rossing; Kara L Cushing-Haugen; Elisa V Bandera; Pamela J Thompson; Susanne K Kjaer; Estrid Hogdall; Penelope M Webb; David G Huntsman; Kirstin B Moysich; Galina Lurie; Roberta B Ness; Daniel O Stram; Lynda Roman; Malcolm C Pike; Celeste Leigh Pearce; Ovarian Cancer Association Consortium

doi:10.1097/EDE.0000000000001175

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Estrogen Plus Progestin Hormone Therapy and Ovarian Cancer: A Complicated Relationship Explored

Journal article

Peer reviewed

Estrogen Plus Progestin Hormone Therapy and Ovarian Cancer: A Complicated Relationship Explored

Alice W Lee, Anna H Wu, Ashley Wiensch, Bhramar Mukherjee, Kathryn L Terry, Holly R Harris, Michael E Carney, Allan Jensen, Daniel W Cramer, Andrew Berchuck, …

Epidemiology (Cambridge, Mass.), Vol.31(3), pp.402-408

05/2020

DOI: https://doi.org/10.1097/EDE.0000000000001175

PMID: 32028322

Abstract

Case-Control Studies

Estrogen Replacement Therapy - adverse effects

Female

Humans

Ovarian Neoplasms - epidemiology

Risk Assessment

Menopausal estrogen-alone therapy is a risk factor for endometrial and ovarian cancers. When a progestin is included with the estrogen daily (continuous estrogen-progestin combined therapy), there is no increased risk of endometrial cancer. However, the effect of continuous estrogen-progestin combined therapy on risk of ovarian cancer is less clear. We pooled primary data from five population-based case-control studies in the Ovarian Cancer Association Consortium, including 1509 postmenopausal ovarian cancer cases and 2295 postmenopausal controls. Information on previous menopausal hormonal therapy use, as well as ovarian cancer risk factors, was collected using in-person interviews. Logistic regression was used to assess the association between use of continuous estrogen-progestin combined therapy and risk of ovarian cancer by duration and recency of use and disease histotype. Ever postmenopausal use of continuous estrogen-progestin combined therapy was not associated with increased risk of ovarian cancer overall (OR = 0.85, 95% CI = 0.72, 1.0). A decreased risk was observed for mucinous ovarian cancer (OR = 0.40, 95% CI = 0.18, 0.91). The other main ovarian cancer histotypes did not show an association (endometrioid: OR = 0.86, 95% CI = 0.57, 1.3, clear cell: OR = 0.68, 95% CI = 0.40, 1.2; serous: OR = 0.98, 95% CI = 0.80, 1.2). Given that estrogen-alone therapy has been shown to be associated with increased risk of ovarian cancer, these findings are consistent with the hypothesis that adding a progestin each day ameliorates the carcinogenic effects of estrogen on the cells of origin for all histotypes of ovarian cancer.

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Title: Estrogen Plus Progestin Hormone Therapy and Ovarian Cancer: A Complicated Relationship Explored
Creators: Alice W Lee - From the Department of Public Health, California State University, Fullerton, Fullerton, CA
Anna H Wu - From the Department of Public Health, California State University, Fullerton, Fullerton, CA
Ashley Wiensch - Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
Bhramar Mukherjee - Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
Kathryn L Terry - Harvard T.H. Chan School of Public Health, Boston, MA
Holly R Harris - Department of Epidemiology, University of Washington, Seattle, WA
Michael E Carney - Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI
Allan Jensen - Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
Daniel W Cramer - Harvard T.H. Chan School of Public Health, Boston, MA
Andrew Berchuck - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC
Jennifer Anne Doherty - Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT
Francesmary Modugno - Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
Marc T Goodman - Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
Aliya Alimujiang - Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
Mary Anne Rossing - Department of Epidemiology, University of Washington, Seattle, WA
Kara L Cushing-Haugen - Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
Elisa V Bandera - Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
Pamela J Thompson - Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
Susanne K Kjaer - Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Estrid Hogdall - Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
Penelope M Webb - Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
David G Huntsman - Department of Obstetrics and Gyencology, University of British Columbia, Vancouver, BC, Canada
Kirstin B Moysich - Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY
Galina Lurie - Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI
Roberta B Ness - University of Texas School of Public Health, Houston, TX
Daniel O Stram - Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
Lynda Roman - Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA
Malcolm C Pike - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
Celeste Leigh Pearce - Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
Ovarian Cancer Association Consortium
Publication Details: Epidemiology (Cambridge, Mass.), Vol.31(3), pp.402-408
Date published: 05/2020
Grant note: R03 CA113148 / NCI NIH HHS N01 CN025403 / NCI NIH HHS R01 CA054419 / NCI NIH HHS N01 PC067010 / NCI NIH HHS K07 CA080668 / NCI NIH HHS R01 CA095023 / NCI NIH HHS K22 CA138563 / NCI NIH HHS R03 CA115195 / NCI NIH HHS K07 CA095666 / NCI NIH HHS R01 CA112523 / NCI NIH HHS R01 CA087538 / NCI NIH HHS R01 CA058598 / NCI NIH HHS P01 CA017054 / NCI NIH HHS P50 CA159981 / NCI NIH HHS P30 CA014089 / NCI NIH HHS P50 CA105009 / NCI NIH HHS R01 CA083918 / NCI NIH HHS P30 CA072720 / NCI NIH HHS
Academic Unit: Cancer Epidemiology and Health Outcomes
Language: English
Resource Type: Journal article
Identifiers: 991031665209104646