Estrogen replacement therapy and endometrial cancer risk

Unresolved issues

Louise A. Brinton, Robert N. Hoover, Rodrigue Mortel, Michael L. Berman, George D. Wilbanks, Leo B. Twiggs, Rolland J. Barrett

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

Objective: To clarify several unresolved issues regarding the relationship of estrogens to endometrial cancer risk. Methods: We conducted a hospital-based case-control study involving 300 menopausal women newly diagnosed with epithelial endometrial cancer and 207 population controls matched to the cases for age, race, and residence. Results: Estrogen use significantly increased endometrial cancer risk (adjusted relative risk [RR] 3.0, 95% confidence interval [CI] 1.7–5.1). Although both short-and long-term use appeared to elevate the risk of early-stage tumors, an effect of estrogens on late-stage tumors was observed only for long-term use (RR 2.1, 95% CI 0.7–6.4). A small proportion of women reported having used progestogens simultaneously with estrogens, which was associated with a lower risk (RR 1.8) than use of estrogens alone (RR 3.4). Although the highest risks were for recent users of estrogens, persistent excess risks were seen even for those who had discontinued use of 5 or more years. There were no striking relationships according to the type of estrogen or regimen used, and associations with dose were inconsistent, although women who used low-dose preparations exclusively had the lowest risk. Estrogen injections or creams, used by only 5.9 and 5.1% of the subjects, respectively, were not significant risk factors after adjustment for estrogen pill use. Women who were thin or who smoked cigarettes appeared to be most adversely affected by estrogen use. Estrogen users failed to experience the protective effect normally associated with oral contraceptive use. Conclusion: The effect of estrogens on endometrial cancer risk appears to vary both by usage patterns and by patient characteristics.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalObstetrics and Gynecology
Volume81
Issue number2
StatePublished - 1993
Externally publishedYes

Fingerprint

Estrogen Replacement Therapy
Endometrial Neoplasms
Estrogens
Confidence Intervals
Population Control
Progestins
Oral Contraceptives
Tobacco Products
Case-Control Studies
Neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Brinton, L. A., Hoover, R. N., Mortel, R., Berman, M. L., Wilbanks, G. D., Twiggs, L. B., & Barrett, R. J. (1993). Estrogen replacement therapy and endometrial cancer risk: Unresolved issues. Obstetrics and Gynecology, 81(2), 265-271.

Estrogen replacement therapy and endometrial cancer risk : Unresolved issues. / Brinton, Louise A.; Hoover, Robert N.; Mortel, Rodrigue; Berman, Michael L.; Wilbanks, George D.; Twiggs, Leo B.; Barrett, Rolland J.

In: Obstetrics and Gynecology, Vol. 81, No. 2, 1993, p. 265-271.

Research output: Contribution to journalArticle

Brinton, LA, Hoover, RN, Mortel, R, Berman, ML, Wilbanks, GD, Twiggs, LB & Barrett, RJ 1993, 'Estrogen replacement therapy and endometrial cancer risk: Unresolved issues', Obstetrics and Gynecology, vol. 81, no. 2, pp. 265-271.
Brinton LA, Hoover RN, Mortel R, Berman ML, Wilbanks GD, Twiggs LB et al. Estrogen replacement therapy and endometrial cancer risk: Unresolved issues. Obstetrics and Gynecology. 1993;81(2):265-271.
Brinton, Louise A. ; Hoover, Robert N. ; Mortel, Rodrigue ; Berman, Michael L. ; Wilbanks, George D. ; Twiggs, Leo B. ; Barrett, Rolland J. / Estrogen replacement therapy and endometrial cancer risk : Unresolved issues. In: Obstetrics and Gynecology. 1993 ; Vol. 81, No. 2. pp. 265-271.
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