Is estrogen plus progestin menopausal hormone therapy safe with respect to endometrial cancer risk?
International Journal of Cancer, 05/04/2012
Trabert B et al. – Our findings support that specific categories of estrogen plus progestin use increases endometrial cancer risk, specifically long durations of sequential progestins; while decreased endometrial cancer risk was observed for users of short duration continuous progestins. Risks were highest among thin-to-normal weight women, presumably reflecting their lower endogenous estrogen levels, suggesting that menopausal hormones and obesity increase endometrial cancer through common etiologic pathways.
We evaluated menopausal hormone use and incident endometrial cancer (n=885) in 68,419 postmenopausal women with intact uteri enrolled in the NIH-AARP Diet and Health study.
Participants completed a risk factor questionnaire in 1996-1997 and were followed through 2006.
Among 19,131 women reporting exclusive estrogen plus progestin use, 176 developed endometrial cancer [RR 0.88; 95% CI: 0.74, 1.06].
Long duration (>/=10 years) sequential (<15 days progestin/month) estrogen plus progestin use was positively associated with risk [RR 1.88; 95% CI: 1.36-2.60], whereas continuous (>25 days progestin/month) estrogen plus progestin use was associated with a decreased risk [RR 0.64; 95% CI: 0.49-0.83)].
Increased risk for sequential estrogen plus progestin was seen only among thin-to-normal weight women (BMI <25 kg/m2) [RR 2.53].
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