@article{3165909,
    title = "Menopausal hormone use and ovarian cancer risk: individual participant
meta-analysis of 52 epidemiological studies",
    author = "Gapstur, S. M. and Patel, A. V. and Banks, E. and Dal Maso, L. and and Talamini, R. and Chetrit, A. and Hirsh-Yechezkel, G. and Lubin, F. and and Sadetzki, S. and Beral, V. and Bull, D. and Cairns, B. and Crossley, B. and and Gaitskell, K. and Goodill, A. and Green, J. and Hermon, C. and Key, and T. and Moser, K. and Reeves, G. and Sitas, F. and Collins, R. and Peto, and R. and Gonzalez, C. A. and Lee, N. and Marchbanks, P. and Ory, H. W. and and Peterson, H. B. and Wingo, P. A. and Martin, N. and Silpisornkosol, S. and and Theetranont, C. and Boosiri, B. and Chutivongse, S. and Jimakorn, P. and and Virutamasen, P. and Wongsrichanalai, C. and Goodman, M. T. and and Lidegaard, O. and Kjaer, S. K. and Morch, L. S. and Tjonneland, A. and and Byers, T. and Rohan, T. and Mosgaard, B. and Vessey, M. and Yeates, D. and and Freudenheim, J. L. and Titus, L. J. and Chang-Claude, J. and Kaaks, and R. and Anderson, K. E. and Lazovich, D. and Robien, K. and Hampton, J. and and Newcomb, P. A. and Rossing, M. A. and Thomas, D. B. and Weiss, N. S. and and Lokkegaard, E. and Riboli, E. and Clavel-Chapelon, F. and Cramer, D. and and Hankinson, S. E. and Tamimi, R. M. and Tworoger, S. S. and and Franceschi, S. and La Vecchia, C. and Negri, E. and Adami, H. O. and and Magnusson, C. and Riman, T. and Weiderpass, E. and Wolk, A. and and Schouten, L. J. and van den Brandt, P. A. and Chantarakul, N. and and Koetsawang, S. and Rachawat, D. and Palli, D. and Black, A. and Brinton, and L. A. and Freedman, D. M. and Hartge, P. and Hsing, A. W. and Jnr, J. V. and Lacey and Lissowska, J. and Hoover, R. N. and Schairer, C. and Babb, C. and and Urban, M. and Graff-Iversen, S. and Selmer, R. and Bain, C. J. and and Green, A. C. and Purdie, D. M. and Siskind, V. and Webb, P. M. and and Moysich, K. and McCann, S. E. and Hannaford, P. and Kay, C. and Binns, and C. W. and Lee, A. H. and Zhang, M. and Ness, R. B. and Nasca, P. and and Coogan, P. F. and Palmer, J. R. and Rosenberg, L. and Whittemore, A. and and Katsouyanni, K. and Trichopoulou, A. and Trichopoulos, D. and Tzonou, A. and and Dabancens, A. and Martinez, L. and Molina, R. and Salas, O. and and Lurie, G. and Carney, M. E. and Wilkens, L. R. and Hartman, L. and and Manjer, J. and Olsson, H. and Kumle, M. and Grisso, J. A. and Morgan, M. and and Wheeler, J. E. and Edwards, R. P. and Kelley, J. L. and Modugno, F. and and Onland-Moret, N. C. and Peeters, P. H. M. and Casagrande, J. and and Pike, M. C. and Wu, A. H. and Canfell, K. and Miller, A. B. and Gram, I. and T. and Lund, E. and McGowan, L. and Shu, X. O. and Zheng, W. and Farley, and T. M. M. and Holck, S. and Meirik, O. and Risch, H. A. and Collaborative and Grp Epidemiological",
    journal = "The Lancet Neurology",
    year = "2015",
    volume = "385",
    number = "9980",
    pages = "1835-1842",
    publisher = "EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC",
    doi = "10.1016/S0140-6736(14)61687-1",
    abstract = "Background Half the epidemiological studies with information about
menopausal hormone therapy and ovarian cancer risk remain unpublished,
and some retrospective studies could have been biased by selective
participation or recall. We aimed to assess with minimal bias the
effects of hormone therapy on ovarian cancer risk.
Methods Individual participant datasets from 52 epidemiological studies
were analysed centrally. The principal analyses involved the prospective
studies (with last hormone therapy use extrapolated forwards for up to 4
years). Sensitivity analyses included the retrospective studies.
Adjusted Poisson regressions yielded relative risks (RRs) versus
never-use.
Findings During prospective follow-up, 12 110 postmenopausal women, 55%
(6601) of whom had used hormone therapy, developed ovarian cancer. Among
women last recorded as current users, risk was increased even with <5
years of use (RR 1.43, 95% CI 1.31-1.56; p<0.0001). Combining
current-or-recent use (any duration, but stopped <5 years before
diagnosis) resulted in an RR of 1.37 (95% CI 1.29-1.46; p<0.0001); this
risk was similar in European and American prospective studies and for
oestrogen-only and oestrogen-progestagen preparations, but differed
across the four main tumour types (heterogeneity p<0.0001), being
definitely increased only for the two most common types, serous (RR
1.53, 95% CI 1.40-1.66; p<0.0001) and endometrioid (1.42, 1.20-1.67;
p<0.0001). Risk declined the longer ago use had ceased, although about
10 years after stopping long-duration hormone therapy use there was
still an excess of serous or endometrioid tumours (RR 1.25, 95% CI
1.07-1.46, p=0.005).
Interpretation The increased risk may well be largely or wholly causal;
if it is, women who use hormone therapy for 5 years from around age 50
years have about one extra ovarian cancer per 1000 users and, if its
prognosis is typical, about one extra ovarian cancer death per 1700
users."
}