Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 172, Issue 12, Pages 1394-1403Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwq300
Keywords
endometrial neoplasms; estrogen replacement therapy; norpregnenes; postmenopause; prospective studies
Categories
Funding
- Cancer Research UK
- European Commission
- Ligue contre le Cancer
- Mutuelle Generale de l'Education Nationale
- Institut Gustave Roussy
- Institut National de la Sante et de la Recherche Medicale (France)
- German Cancer Research Center
- German Federal Ministry of Education and Research (Germany)
- Danish Cancer Society (Denmark)
- Spanish Ministry of Health, Instituto de Salud Carlos III Red de Centros Spanish Network for Cooperative Research in Epidemiology and Public Health [C03/09]
- Medical Research Council
- Stroke Association
- British Heart Foundation
- United Kingdom Department of Health
- United Kingdom Food Standards Agency
- Wellcome Trust (United Kingdom)
- Italian Association for Research on Cancer
- Italian National Research Council (Italy)
- Dutch Ministry of Public Health, Welfare and Sports
- Dutch Ministry of Health
- Dutch Prevention Funds
- LK Research Funds
- Dutch Zorg Onderzoek Nederland
- World Cancer Research Fund (the Netherlands)
- European Research Council (IDEAS Advanced Research Grant Transcriptomics in Cancer Epidemiology)
- Research Council of Norway (Norway)
- Medical Research Council [G0401527, MC_U106179471] Funding Source: researchfish
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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.
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