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The prevention of breast cancer through reduced ovarian steroid exposure.
Acta Oncol 1992; 31(2):167-74AO

Abstract

Analysis of epidemiologic data on cancers of the breast, ovary and endometrium; the effects of endogenous hormones on cell proliferation; and current carcinogenesis concepts, suggest that hormonal contraceptives can be developed that will reduce lifetime risk of all 3 cancers. The 'unopposed-estrogen hypothesis' accounts for endometrial cancer risk factors. Ovarian cancer risk is closely related to the total frequency of ovulation. The risk of breast cancer can be explained by an 'estrogen-plus-progestogen hypothesis'. On the basis of this analysis an hormonal contraceptive regimen has been developed consisting of a gonadotropin-releasing hormone agonist (GnRHA) plus continuous low-dose add-back estrogen and a short course of progestogen every fourth month. The total dose of add-back estrogen is estimated to be approximately 38% that in present-day low-dose combination-type oral contraceptives (COCs). The total dose of progestogen is approximately 15% that in COCs. This regimen prevents ovulation and should thus reduce ovarian cancer risk. It also reduces the exposure of the endometrium to unopposed estrogen, and the exposure of the breast to estrogen-plus-progestogen. It is estimated that use of such a regimen for 10 years will only reduce lifetime risk of endometrial cancer by one-sixth, but lifetime risk of ovarian cancer is estimated to be reduced by two-thirds, and lifetime risk of breast cancer is estimated to be reduced by one-half.

Authors+Show Affiliations

University of Southern California School of Medicine, Department of Preventive Medicine, Los Angeles 90033-9987.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

1622631

Citation

Spicer, D V., and M C. Pike. "The Prevention of Breast Cancer Through Reduced Ovarian Steroid Exposure." Acta Oncologica (Stockholm, Sweden), vol. 31, no. 2, 1992, pp. 167-74.
Spicer DV, Pike MC. The prevention of breast cancer through reduced ovarian steroid exposure. Acta Oncol. 1992;31(2):167-74.
Spicer, D. V., & Pike, M. C. (1992). The prevention of breast cancer through reduced ovarian steroid exposure. Acta Oncologica (Stockholm, Sweden), 31(2), pp. 167-74.
Spicer DV, Pike MC. The Prevention of Breast Cancer Through Reduced Ovarian Steroid Exposure. Acta Oncol. 1992;31(2):167-74. PubMed PMID: 1622631.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The prevention of breast cancer through reduced ovarian steroid exposure. AU - Spicer,D V, AU - Pike,M C, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez KW - Americas KW - Biology KW - Breast Cancer--prevention and control KW - California KW - Cancer KW - Clinical Research KW - Clinical Trials KW - Contraception KW - Contraceptive Agents KW - Contraceptive Agents, Female KW - Contraceptive Agents, Progestin KW - Contraceptive Methods KW - Contraceptive Mode Of Action KW - Cytology KW - Developed Countries KW - Diseases KW - Endocrine System KW - Endometrial Cancer--prevention and control KW - Estrogens KW - Family Planning KW - Hormone Antagonists KW - Hormones KW - Medroxyprogesterone Acetate KW - Neoplasms KW - North America KW - Northern America KW - Oral Contraceptives KW - Oral Contraceptives, Combined KW - Ovarian Cancer KW - Ovulation Suppression KW - Physiology KW - Research Methodology KW - Research Report KW - United States SP - 167 EP - 74 JF - Acta oncologica (Stockholm, Sweden) JO - Acta Oncol VL - 31 IS - 2 N2 - Analysis of epidemiologic data on cancers of the breast, ovary and endometrium; the effects of endogenous hormones on cell proliferation; and current carcinogenesis concepts, suggest that hormonal contraceptives can be developed that will reduce lifetime risk of all 3 cancers. The 'unopposed-estrogen hypothesis' accounts for endometrial cancer risk factors. Ovarian cancer risk is closely related to the total frequency of ovulation. The risk of breast cancer can be explained by an 'estrogen-plus-progestogen hypothesis'. On the basis of this analysis an hormonal contraceptive regimen has been developed consisting of a gonadotropin-releasing hormone agonist (GnRHA) plus continuous low-dose add-back estrogen and a short course of progestogen every fourth month. The total dose of add-back estrogen is estimated to be approximately 38% that in present-day low-dose combination-type oral contraceptives (COCs). The total dose of progestogen is approximately 15% that in COCs. This regimen prevents ovulation and should thus reduce ovarian cancer risk. It also reduces the exposure of the endometrium to unopposed estrogen, and the exposure of the breast to estrogen-plus-progestogen. It is estimated that use of such a regimen for 10 years will only reduce lifetime risk of endometrial cancer by one-sixth, but lifetime risk of ovarian cancer is estimated to be reduced by two-thirds, and lifetime risk of breast cancer is estimated to be reduced by one-half. SN - 0284-186X UR - https://www.unboundmedicine.com/medline/citation/1622631/The_prevention_of_breast_cancer_through_reduced_ovarian_steroid_exposure_ L2 - http://www.tandfonline.com/doi/full/10.3109/02841869209088898 DB - PRIME DP - Unbound Medicine ER -