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Cancer Causes & Control
Published in: Cancer Causes & Control 11/2019

01-11-2019 | Ovarian Cancer | Original Paper

Circulating estrogens and postmenopausal ovarian and endometrial cancer risk among current hormone users in the Women’s Health Initiative Observational Study

Authors: Britton Trabert, Sally B. Coburn, Roni T. Falk, JoAnn E. Manson, Louise A. Brinton, Margery L. Gass, Lewis H. Kuller, Thomas E. Rohan, Ruth M. Pfeiffer, Lihong Qi, Marcia L. Stefanick, Nicolas Wentzensen, Garnet L. Anderson, Xia Xu

Published in: Cancer Causes & Control | Issue 11/2019

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Abstract

Purpose

Menopausal hormone therapy (MHT) use induces alterations in circulating estrogens/estrogen metabolites, which may contribute to the altered risk of reproductive tract cancers among current users. Thus, the current study assessed associations between circulating estrogens/estrogen metabolites and ovarian and endometrial cancer risk among MHT users.

Methods

We conducted a nested case–control study among postmenopausal women using MHT at baseline in the Women’s Health Initiative Observational Study (179 ovarian cancers, 396 controls; 230 endometrial cancers, 253 controls). Multivariable logistic regression was utilized to estimate odds ratios and 95% confidence intervals overall and by subtype.

Results

Estrogen/estrogen metabolite levels were not associated with overall or serous ovarian cancer risk, examined separately. However, unconjugated estradiol was positively associated with non-serous ovarian cancer risk [quintile 5 vs. quintile 1: 3.01 (1.17–7.73); p-trend = 0.03; p-het < 0.01]. Endometrial cancer risk was unrelated to estrogen/estrogen metabolite levels among women who took combined estrogen/progestin therapy (EPT).

Conclusions

These findings provide novel evidence that may support a heterogeneous hormonal etiology across ovarian cancer subtypes. Circulating estrogens did not influence endometrial cancer risk among women with EPT-induced high-estrogen levels. Larger studies are needed to delineate the relationship between ovarian/endometrial cancer subtypes and estrogen levels in the context of MHT use.
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Metadata
Title
Circulating estrogens and postmenopausal ovarian and endometrial cancer risk among current hormone users in the Women’s Health Initiative Observational Study
Authors
Britton Trabert
Sally B. Coburn
Roni T. Falk
JoAnn E. Manson
Louise A. Brinton
Margery L. Gass
Lewis H. Kuller
Thomas E. Rohan
Ruth M. Pfeiffer
Lihong Qi
Marcia L. Stefanick
Nicolas Wentzensen
Garnet L. Anderson
Xia Xu
Publication date
01-11-2019
Publisher
Springer International Publishing
Published in
Cancer Causes & Control / Issue 11/2019
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-019-01233-8

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