Association Between Menopausal Estrogen-Only Therapy and Ovarian Carcinoma Risk

Alice W Lee; Roberta B Ness; Lynda D Roman; Kathryn L Terry; Joellen M Schildkraut; Jenny Chang-Claude; Jennifer A Doherty; Usha Menon; Daniel W Cramer; Simon A Gayther; Harvey Risch; Aleksandra Gentry-Maharaj; Marc T Goodman; Francesmary Modugno; Ursula Eilber; Kirsten B Moysich; Andrew Berchuck; Mary Anne Rossing; Allan Jensen; Kristine G Wicklund; Kara L Cushing-Haugen; Estrid Hogdall; Anja Rudolph; Pamela J Thompson; Lynne R Wilkens; Susanne K Kjaer; Michael E Carney; Daniel O Stram; Susan J Ramus; Anna H Wu; Malcolm C Pike; Celeste Leigh Pearce; Ovarian Cancer Association Consortium

doi:10.1097/AOG.0000000000001387

Association Between Menopausal Estrogen-Only Therapy and Ovarian Carcinoma Risk

Alice W Lee, Roberta B Ness, Lynda D Roman, Kathryn L Terry, Joellen M Schildkraut, Jenny Chang-Claude, Jennifer A Doherty, Usha Menon, Daniel W Cramer, Simon A Gayther, Harvey Risch, Aleksandra Gentry-Maharaj, Marc T Goodman, Francesmary Modugno, Ursula Eilber, Kirsten B Moysich, Andrew Berchuck, Mary Anne Rossing, Allan Jensen, Kristine G WicklundKara L Cushing-Haugen, Estrid Hogdall, Anja Rudolph, Pamela J Thompson, Lynne R Wilkens, Susanne K Kjaer, Michael E Carney, Daniel O Stram, Susan J Ramus, Anna H Wu, Malcolm C Pike, Celeste Leigh Pearce, Ovarian Cancer Association Consortium

Department of Clinical Medicine

20 Citations (Scopus)

Abstract

OBJECTIVE: To describe the association between postmenopausal estrogen-only therapy use and risk of ovarian carcinoma, specifically with regard to disease histotype and duration and timing of use. METHODS: We conducted a pooled analysis of 906 women with ovarian carcinoma and 1,220 women in a control group; all 2,126 women included reported having had a hysterectomy. Ten population-based case-control studies participating in the Ovarian Cancer Association Consortium, an international consortium whose goal is to combine data from many studies with similar methods so reliable assessments of risk factors can be determined, were included. Self-reported questionnaire data from each study were harmonized and conditional logistic regression was used to examine estrogen-only therapy's histotypespecific and duration and recency of use associations. RESULTS: Forty-three and a half percent of the women in the control group reported previous use of estrogen-only therapy. Compared with them, current or recent estrogenonly therapy use was associated with an increased risk for the serous (51.4%, odds ratio [OR] 1.63, 95% confidence interval [CI] 1.27-2.09) and endometrioid (48.6%, OR 2.00, 95% CI 1.17-3.41) histotypes. In addition, statistically significant trends in risk according to duration of use were seen among current or recent postmenopausal estrogen-only therapy users for both ovarian carcinoma histotypes (Ptrend,.001 for serous and endometrioid). Compared with women in the control group, current or recent users for 10 years or more had increased risks of serous ovarian carcinoma (36.8%, OR 1.73, 95% CI 1.26-2.38) and endometrioid ovarian carcinoma (34.9%, OR 4.03, 95% CI 1.91-8.49). CONCLUSION: We found evidence of an increased risk of serous and endometrioid ovarian carcinoma associated with postmenopausal estrogen-only therapy use, particularly of long duration. These findings emphasize that risk may be associated with extended estrogen-only therapy use.

Original language	English
Journal	Obstetrics and Gynecology
Volume	127
Issue number	5
Pages (from-to)	828-36
Number of pages	9
ISSN	0029-7844
DOIs	https://doi.org/10.1097/AOG.0000000000001387
Publication status	Published - 1 May 2016

Keywords

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/AOG.0000000000001387

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Lee, A. W., Ness, R. B., Roman, L. D., Terry, K. L., Schildkraut, J. M., Chang-Claude, J., Doherty, J. A., Menon, U., Cramer, D. W., Gayther, S. A., Risch, H., Gentry-Maharaj, A., Goodman, M. T., Modugno, F., Eilber, U., Moysich, K. B., Berchuck, A., Rossing, M. A., Jensen, A., ... Ovarian Cancer Association Consortium (2016). Association Between Menopausal Estrogen-Only Therapy and Ovarian Carcinoma Risk. Obstetrics and Gynecology, 127(5), 828-36. https://doi.org/10.1097/AOG.0000000000001387

Lee, AW, Ness, RB, Roman, LD, Terry, KL, Schildkraut, JM, Chang-Claude, J, Doherty, JA, Menon, U, Cramer, DW, Gayther, SA, Risch, H, Gentry-Maharaj, A, Goodman, MT, Modugno, F, Eilber, U, Moysich, KB, Berchuck, A, Rossing, MA, Jensen, A, Wicklund, KG, Cushing-Haugen, KL, Hogdall, E, Rudolph, A, Thompson, PJ, Wilkens, LR, Kjaer, SK, Carney, ME, Stram, DO, Ramus, SJ, Wu, AH, Pike, MC, Pearce, CL & Ovarian Cancer Association Consortium 2016, 'Association Between Menopausal Estrogen-Only Therapy and Ovarian Carcinoma Risk', Obstetrics and Gynecology, vol. 127, no. 5, pp. 828-36. https://doi.org/10.1097/AOG.0000000000001387

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title = "Association Between Menopausal Estrogen-Only Therapy and Ovarian Carcinoma Risk",

abstract = "OBJECTIVE: To describe the association between postmenopausal estrogen-only therapy use and risk of ovarian carcinoma, specifically with regard to disease histotype and duration and timing of use. METHODS: We conducted a pooled analysis of 906 women with ovarian carcinoma and 1,220 women in a control group; all 2,126 women included reported having had a hysterectomy. Ten population-based case-control studies participating in the Ovarian Cancer Association Consortium, an international consortium whose goal is to combine data from many studies with similar methods so reliable assessments of risk factors can be determined, were included. Self-reported questionnaire data from each study were harmonized and conditional logistic regression was used to examine estrogen-only therapy's histotypespecific and duration and recency of use associations. RESULTS: Forty-three and a half percent of the women in the control group reported previous use of estrogen-only therapy. Compared with them, current or recent estrogenonly therapy use was associated with an increased risk for the serous (51.4%, odds ratio [OR] 1.63, 95% confidence interval [CI] 1.27-2.09) and endometrioid (48.6%, OR 2.00, 95% CI 1.17-3.41) histotypes. In addition, statistically significant trends in risk according to duration of use were seen among current or recent postmenopausal estrogen-only therapy users for both ovarian carcinoma histotypes (Ptrend,.001 for serous and endometrioid). Compared with women in the control group, current or recent users for 10 years or more had increased risks of serous ovarian carcinoma (36.8%, OR 1.73, 95% CI 1.26-2.38) and endometrioid ovarian carcinoma (34.9%, OR 4.03, 95% CI 1.91-8.49). CONCLUSION: We found evidence of an increased risk of serous and endometrioid ovarian carcinoma associated with postmenopausal estrogen-only therapy use, particularly of long duration. These findings emphasize that risk may be associated with extended estrogen-only therapy use.",

keywords = "Journal Article",

author = "Lee, {Alice W} and Ness, {Roberta B} and Roman, {Lynda D} and Terry, {Kathryn L} and Schildkraut, {Joellen M} and Jenny Chang-Claude and Doherty, {Jennifer A} and Usha Menon and Cramer, {Daniel W} and Gayther, {Simon A} and Harvey Risch and Aleksandra Gentry-Maharaj and Goodman, {Marc T} and Francesmary Modugno and Ursula Eilber and Moysich, {Kirsten B} and Andrew Berchuck and Rossing, {Mary Anne} and Allan Jensen and Wicklund, {Kristine G} and Cushing-Haugen, {Kara L} and Estrid Hogdall and Anja Rudolph and Thompson, {Pamela J} and Wilkens, {Lynne R} and Kjaer, {Susanne K} and Carney, {Michael E} and Stram, {Daniel O} and Ramus, {Susan J} and Wu, {Anna H} and Pike, {Malcolm C} and Pearce, {Celeste Leigh} and {Ovarian Cancer Association Consortium}",

year = "2016",

month = may,

day = "1",

doi = "10.1097/AOG.0000000000001387",

language = "English",

volume = "127",

pages = "828--36",

journal = "Obstetrics and Gynecology",

issn = "0029-7844",

publisher = "Lippincott Williams & Wilkins",

number = "5",

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TY - JOUR

T1 - Association Between Menopausal Estrogen-Only Therapy and Ovarian Carcinoma Risk

AU - Lee, Alice W

AU - Ness, Roberta B

AU - Roman, Lynda D

AU - Terry, Kathryn L

AU - Schildkraut, Joellen M

AU - Chang-Claude, Jenny

AU - Doherty, Jennifer A

AU - Menon, Usha

AU - Cramer, Daniel W

AU - Gayther, Simon A

AU - Risch, Harvey

AU - Gentry-Maharaj, Aleksandra

AU - Goodman, Marc T

AU - Modugno, Francesmary

AU - Eilber, Ursula

AU - Moysich, Kirsten B

AU - Berchuck, Andrew

AU - Rossing, Mary Anne

AU - Jensen, Allan

AU - Wicklund, Kristine G

AU - Cushing-Haugen, Kara L

AU - Hogdall, Estrid

AU - Rudolph, Anja

AU - Thompson, Pamela J

AU - Wilkens, Lynne R

AU - Kjaer, Susanne K

AU - Carney, Michael E

AU - Stram, Daniel O

AU - Ramus, Susan J

AU - Wu, Anna H

AU - Pike, Malcolm C

AU - Pearce, Celeste Leigh

AU - Ovarian Cancer Association Consortium

PY - 2016/5/1

Y1 - 2016/5/1

N2 - OBJECTIVE: To describe the association between postmenopausal estrogen-only therapy use and risk of ovarian carcinoma, specifically with regard to disease histotype and duration and timing of use. METHODS: We conducted a pooled analysis of 906 women with ovarian carcinoma and 1,220 women in a control group; all 2,126 women included reported having had a hysterectomy. Ten population-based case-control studies participating in the Ovarian Cancer Association Consortium, an international consortium whose goal is to combine data from many studies with similar methods so reliable assessments of risk factors can be determined, were included. Self-reported questionnaire data from each study were harmonized and conditional logistic regression was used to examine estrogen-only therapy's histotypespecific and duration and recency of use associations. RESULTS: Forty-three and a half percent of the women in the control group reported previous use of estrogen-only therapy. Compared with them, current or recent estrogenonly therapy use was associated with an increased risk for the serous (51.4%, odds ratio [OR] 1.63, 95% confidence interval [CI] 1.27-2.09) and endometrioid (48.6%, OR 2.00, 95% CI 1.17-3.41) histotypes. In addition, statistically significant trends in risk according to duration of use were seen among current or recent postmenopausal estrogen-only therapy users for both ovarian carcinoma histotypes (Ptrend,.001 for serous and endometrioid). Compared with women in the control group, current or recent users for 10 years or more had increased risks of serous ovarian carcinoma (36.8%, OR 1.73, 95% CI 1.26-2.38) and endometrioid ovarian carcinoma (34.9%, OR 4.03, 95% CI 1.91-8.49). CONCLUSION: We found evidence of an increased risk of serous and endometrioid ovarian carcinoma associated with postmenopausal estrogen-only therapy use, particularly of long duration. These findings emphasize that risk may be associated with extended estrogen-only therapy use.

AB - OBJECTIVE: To describe the association between postmenopausal estrogen-only therapy use and risk of ovarian carcinoma, specifically with regard to disease histotype and duration and timing of use. METHODS: We conducted a pooled analysis of 906 women with ovarian carcinoma and 1,220 women in a control group; all 2,126 women included reported having had a hysterectomy. Ten population-based case-control studies participating in the Ovarian Cancer Association Consortium, an international consortium whose goal is to combine data from many studies with similar methods so reliable assessments of risk factors can be determined, were included. Self-reported questionnaire data from each study were harmonized and conditional logistic regression was used to examine estrogen-only therapy's histotypespecific and duration and recency of use associations. RESULTS: Forty-three and a half percent of the women in the control group reported previous use of estrogen-only therapy. Compared with them, current or recent estrogenonly therapy use was associated with an increased risk for the serous (51.4%, odds ratio [OR] 1.63, 95% confidence interval [CI] 1.27-2.09) and endometrioid (48.6%, OR 2.00, 95% CI 1.17-3.41) histotypes. In addition, statistically significant trends in risk according to duration of use were seen among current or recent postmenopausal estrogen-only therapy users for both ovarian carcinoma histotypes (Ptrend,.001 for serous and endometrioid). Compared with women in the control group, current or recent users for 10 years or more had increased risks of serous ovarian carcinoma (36.8%, OR 1.73, 95% CI 1.26-2.38) and endometrioid ovarian carcinoma (34.9%, OR 4.03, 95% CI 1.91-8.49). CONCLUSION: We found evidence of an increased risk of serous and endometrioid ovarian carcinoma associated with postmenopausal estrogen-only therapy use, particularly of long duration. These findings emphasize that risk may be associated with extended estrogen-only therapy use.

KW - Journal Article

U2 - 10.1097/AOG.0000000000001387

DO - 10.1097/AOG.0000000000001387

M3 - Journal article

C2 - 27054934

SN - 0029-7844

VL - 127

SP - 828

EP - 836

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

IS - 5

ER -

Association Between Menopausal Estrogen-Only Therapy and Ovarian Carcinoma Risk

Abstract

Keywords

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