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Menopausal hormone therapy and risk of ovarian cancer in the European prospective investigation into cancer and nutrition

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Abstract

The association between menopausal hormone therapy (HT) and risk of ovarian cancer was assessed among 126,920 post-menopausal women recruited into the European Prospective Investigation into Cancer and Nutrition. After an average of 9-year follow-up, 424 incident ovarian cancers were diagnosed. Cox models adjusted for body mass index, smoking status, unilateral ovariectomy, simple hysterectomy, age at menarche, number of full-term pregnancies, and duration of oral contraceptives were used. Compared with baseline never use, current use of any HT was positively associated with risk (HR [hazard ratio], 1.29; 95% CI [confidence interval], 1.01–1.65), while former use was not (HR, 0.96; 95% CI, 0.70–1.30). Current estrogen-only HT was associated with a 63% higher risk (HR, 1.63; 95% CI, 1.08–2.47), while current estrogen plus progestin was associated with a smaller and non-significant higher risk (HR, 1.20; 95% CI, 0.89–1.62). Use of tibolone was associated with a twofold greater risk (HR, 2.19; 95% CI, 1.06–4.50), but was based on small numbers. In conclusion, women who currently use HT have a moderate increased risk of ovarian cancer, and which may be stronger for estrogen-only than estrogen plus progestin preparations.

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Acknowledgments

The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue contre le Cancer, Société 3 M, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Medicale (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); Ministry of Health and Social Solidarity, Stavros Niarchos Foundation and Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF); Statistics Netherlands (The Netherlands); Norwegian Cancer Society (Norway); Health Research Fund (FIS), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skåne and Västerbotten (Sweden); Cancer Research UK, Medical Research Council (United Kingdom).

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Authors and Affiliations

  1. Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK

    Konstantinos K. Tsilidis, Naomi E. Allen & Timothy J. Key

  2. Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany

    Laure Dossus, Rudolf Kaaks & Annekatrin Lukanova

  3. Department of Community Medicine, University of Tromsø, Tromsø, Norway

    Kjersti Bakken, Eiliv Lund & Inger T. Gram

  4. Inserm, Centre for Research in Epidemiology and Population Health, U1018, Institut Gustave Roussy, 94805, Villejuif, France

    Agnès Fournier, Marie-Christine Boutron-Ruault & Francoise Clavel-Chapelon

  5. Paris South University, UMRS 1018, 94805, Villejuif, France

    Agnès Fournier, Marie-Christine Boutron-Ruault & Francoise Clavel-Chapelon

  6. Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark

    Christina C. Dahm & Kim Overvad

  7. Department of Cardiology, Aarhus University Hospital, Aalborg, Denmark

    Christina C. Dahm

  8. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    Louise Hansen & Anne Tjønneland

  9. International Agency for Research on Cancer, Lyon, France

    Sabina Rinaldi & Isabelle Romieu

  10. Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany

    Heiner Boeing & Madlen Schütze

  11. WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece

    Vassiliki Benetou

  12. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy

    Domenico Palli

  13. Department of Preventive and Predictive Medicine, National Cancer Institute, Milan, Italy

    Franco Berrino

  14. Istituto di Ricovero e Cura a Carattere Scientifico–Centro di Riferimento Oncologico di Basilicata, Unit of Clinical Epidemiolgy, Biostatistics and Cancer Registry, Rionero in Vulture, Italy

    Rocco Galasso

  15. Department of Oncology, Azienda Ospedaliera “Civile—M.P.Arezzo”, Cancer Registry and Histopathology Unit, Ragusa, Italy

    Rosario Tumino

  16. Unit of Cancer Epidemiology, University of Turin, Turin, Italy

    Carlotta Sacerdote

  17. National Institute for Public Health and the Environment, Bilthoven, The Netherlands

    H. Bas Bueno-de-Mesquita & Fränzel J. B. van Duijnhoven

  18. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    Marieke G. M. Braem & N. Charlotte Onland-Moret

  19. Public Health and Participation Directorate, Health and Health Care Services Council, Asturias, Spain

    Laudina Rodríguez

  20. Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain

    Eric J. Duell

  21. Andalusian School of Public Health and CIBER de Epidemiología y Salud Pública, Granada, Spain

    María-José Sánchez

  22. Department of Epidemiology, Murcia Regional Health Authority and CIBER de Epidemiología y Salud Pública, Murcia, Spain

    José María Huerta

  23. Public Health Institute of Navarra and CIBER de Epidemiología y Salud Pública, Pamplona, Spain

    Eva Ardanaz

  24. Health Division of Gipuzkoa, Basque Government and IIS BioDonostia and CIBER de Epidemiología y Salud Pública, San Sebastian, Spain

    Pilar Amiano

  25. Clinical Gerontology Unit, University of Cambridge, Cambridge, UK

    Kay-Tee Khaw

  26. Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK

    Nick Wareham

  27. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK

    Elio Riboli

Authors
  1. Konstantinos K. Tsilidis
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  2. Naomi E. Allen
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  3. Timothy J. Key
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  4. Laure Dossus
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  5. Rudolf Kaaks
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  6. Kjersti Bakken
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  7. Eiliv Lund
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  8. Agnès Fournier
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  9. Christina C. Dahm
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  10. Kim Overvad
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  11. Louise Hansen
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  12. Anne Tjønneland
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  13. Sabina Rinaldi
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  14. Isabelle Romieu
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  15. Marie-Christine Boutron-Ruault
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  16. Francoise Clavel-Chapelon
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  17. Annekatrin Lukanova
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  18. Heiner Boeing
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  19. Madlen Schütze
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  20. Vassiliki Benetou
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  21. Domenico Palli
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  22. Franco Berrino
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  23. Rocco Galasso
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  24. Rosario Tumino
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  25. Carlotta Sacerdote
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  26. H. Bas Bueno-de-Mesquita
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  27. Fränzel J. B. van Duijnhoven
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  28. Marieke G. M. Braem
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  29. N. Charlotte Onland-Moret
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  30. Inger T. Gram
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  31. Laudina Rodríguez
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  32. Eric J. Duell
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  33. María-José Sánchez
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  34. José María Huerta
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  35. Eva Ardanaz
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  36. Pilar Amiano
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  37. Kay-Tee Khaw
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  38. Nick Wareham
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  39. Elio Riboli
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Corresponding author

Correspondence to Konstantinos K. Tsilidis.

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Tsilidis, K.K., Allen, N.E., Key, T.J. et al. Menopausal hormone therapy and risk of ovarian cancer in the European prospective investigation into cancer and nutrition. Cancer Causes Control 22, 1075–1084 (2011). https://doi.org/10.1007/s10552-011-9782-z

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  • DOI: https://doi.org/10.1007/s10552-011-9782-z

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