Ερευνητικό υλικό ΕΚΠΑ

Menopausal hormone use and ovarian cancer risk: individual participant
meta-analysis of 52 epidemiological studies

Αγγλικά

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menopausal hormone therapy and ovarian cancer risk remain unpublished,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.

2015

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Patel, A. V.
Banks, E.
Dal Maso, L. and
Talamini, R.
Chetrit, A.
Hirsh-Yechezkel, G.
Lubin, F. and
Sadetzki, S.
Beral, V.
Bull, D.
Cairns, B.
Crossley, B.
and Gaitskell, K.
Goodill, A.
Green, J.
Hermon, C.
Key,
T.
Moser, K.
Reeves, G.
Sitas, F.
Collins, R.
Peto,
R.
Gonzalez, C. A.
Lee, N.
Marchbanks, P.
Ory, H. W. and
Peterson, H. B.
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Jimakorn, P.
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Siskind, V.
Webb, P. M. and
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McCann, S. E.
Hannaford, P.
Kay, C.
Binns,
C. W.
Lee, A. H.
Zhang, M.
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Nasca, P. and
Coogan, P. F.
Palmer, J. R.
Rosenberg, L.
Whittemore, A. and
Katsouyanni, K.
Trichopoulou, A.
Trichopoulos, D.
Tzonou, A.
and Dabancens, A.
Martinez, L.
Molina, R.
Salas, O. and
Lurie, G.
Carney, M. E.
Wilkens, L. R.
Hartman, L. and
Manjer, J.
Olsson, H.
Kumle, M.
Grisso, J. A.
Morgan, M.
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Edwards, R. P.
Kelley, J. L.
Modugno, F.
and Onland-Moret, N. C.
Peeters, P. H. M.
Casagrande, J. and
Pike, M. C.
Wu, A. H.
Canfell, K.
Miller, A. B.
Gram, I.
T.
Lund, E.
McGowan, L.
Shu, X. O.
Zheng, W.
Farley,
T. M. M.
Holck, S.
Meirik, O.
Risch, H. A.
Collaborative
Grp Epidemiological

The Lancet Neurology

EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC

385

9980

1835-1842

https://doi.org/10.1016/S0140-6736(14)61687-1

10.1016/S0140-6736(14)61687-1

https://pergamos.lib.uoa.gr/uoa/dl/object/3165909