期刊
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
卷 19, 期 2, 页码 475-483出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-09-0712
关键词
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资金
- National Cancer Institute [R01 CA91019, R01 CA77398, N01-PC-35136]
- California Breast Cancer Research Fund [97-10500]
- California Department of Health Services
- California Health and Safety Code [103885]
- Northern California Cancer Center [N01-PC-35139]
- University of Southern California [N02-PC-15105]
- Centers for Disease Control and Prevention [U55/CCR921930-02]
Estrogen-alone therapy (ET) or estrogen and progestin (EPT) as menopausal hormone therapy (HT) has been commonly used to alleviate menopausal symptoms. Treatments containing >= 10 days per month of progestin are considered relatively safe with respect to endometrial cancer risk. However, the endometrial safety of long-term EPT regimens is uncertain. We conducted a case-control study of 311 invasive endometrial cancer cases and 570 controls nested within the California Teachers Study cohort. We used unconditional logistic regression to obtain odds ratios (OR) and 95% confidence intervals (95% CI) for the association between long-term HT use and endometrial cancer risk, and to assess the modifying effect of body mass index (BMI). Long-term (>= 10 years) use of ET, sequential EPT with <10 days per month progestin, and continuous-combined EPT (>= 25 days/month progestin) were all associated with an elevated risk of endometrial cancer (OR, 4.5; 95% CI, 2.5-8.1; OR, 4.4; 95% CI, 1.7-11.2; and OR, 2.1; 95% CI, 1.3-3.3, respectively; all P-trend < 0.001). The risk associated with short-term use was elevated only for ET preparations. The association for continuous-combined EPT was confined to thinner women (BMI, < 25 kg/m(2); P-interaction = 0.03). Among heavier women (BMI, >= 25 kg/m(2)), use of continuous-combined EPT was associated with a statistically nonsignificant reduction in risk. These findings confirm that long-term use of ET, sequential EPT, or, among normal weight women, continuous-combined EPT is associated with increased risk of endometrial cancer. Cancer Epidemiol Biomarkers Prev; 19(2); 475-83. (c) 2010 AACR.
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