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

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.

• 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
• Journal: Cancer causes & control : CCC (Cancer Causes Control) Vol. 30 Issue 11 Pg. 1201-1211 (Nov 2019) ISSN: 1573-7225 [Electronic] Netherlands
• PMID: 31542834 (Publication Type: Journal Article, Observational Study)

Chemical References

• Estrogens
• Estradiol

Topics

• Aged
• Endometrial Neoplasms (blood)
• Estradiol (blood)
• Estrogens (blood)
• Female
• Hormone Replacement Therapy
• Humans
• Middle Aged
• Ovarian Neoplasms (blood)
• Postmenopause
• Risk