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Circulating estrogens and postmenopausal ovarian and endometrial cancer risk among current hormone users in the Women's Health Initiative Observational Study.
Cancer Causes Control. 2019 Nov; 30(11):1201-1211.CC

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+Show Affiliations

Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9768, USA. britton.trabert@nih.gov.Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9768, USA.Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9768, USA.Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9768, USA.Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9768, USA.Public Health Sciences, School of Medicine, UC Davis, Sacramento, CA, USA.Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9768, USA.Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD, USA.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

31542834

Citation

Trabert, Britton, et al. "Circulating Estrogens and Postmenopausal Ovarian and Endometrial Cancer Risk Among Current Hormone Users in the Women's Health Initiative Observational Study." Cancer Causes & Control : CCC, vol. 30, no. 11, 2019, pp. 1201-1211.
Trabert B, Coburn SB, Falk RT, et al. Circulating estrogens and postmenopausal ovarian and endometrial cancer risk among current hormone users in the Women's Health Initiative Observational Study. Cancer Causes Control. 2019;30(11):1201-1211.
Trabert, B., Coburn, S. B., Falk, R. T., Manson, J. E., Brinton, L. A., Gass, M. L., Kuller, L. H., Rohan, T. E., Pfeiffer, R. M., Qi, L., Stefanick, M. L., Wentzensen, N., Anderson, G. L., & Xu, X. (2019). Circulating estrogens and postmenopausal ovarian and endometrial cancer risk among current hormone users in the Women's Health Initiative Observational Study. Cancer Causes & Control : CCC, 30(11), 1201-1211. https://doi.org/10.1007/s10552-019-01233-8
Trabert B, et al. Circulating Estrogens and Postmenopausal Ovarian and Endometrial Cancer Risk Among Current Hormone Users in the Women's Health Initiative Observational Study. Cancer Causes Control. 2019;30(11):1201-1211. PubMed PMID: 31542834.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circulating estrogens and postmenopausal ovarian and endometrial cancer risk among current hormone users in the Women's Health Initiative Observational Study. AU - Trabert,Britton, AU - Coburn,Sally B, AU - Falk,Roni T, AU - Manson,JoAnn E, AU - Brinton,Louise A, AU - Gass,Margery L, AU - Kuller,Lewis H, AU - Rohan,Thomas E, AU - Pfeiffer,Ruth M, AU - Qi,Lihong, AU - Stefanick,Marcia L, AU - Wentzensen,Nicolas, AU - Anderson,Garnet L, AU - Xu,Xia, Y1 - 2019/09/21/ PY - 2019/06/24/received PY - 2019/09/11/accepted PY - 2020/11/01/pmc-release PY - 2019/9/23/pubmed PY - 2020/1/8/medline PY - 2019/9/23/entrez KW - Current hormone therapy users KW - Endogenous estrogens KW - Endometrial cancer KW - Estrogen metabolites KW - Nested case–control study KW - Ovarian cancer SP - 1201 EP - 1211 JF - Cancer causes & control : CCC JO - Cancer Causes Control VL - 30 IS - 11 N2 - 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. SN - 1573-7225 UR - https://www.unboundmedicine.com/medline/citation/31542834/Circulating_estrogens_and_postmenopausal_ovarian_and_endometrial_cancer_risk_among_current_hormone_users_in_the_Women's_Health_Initiative_Observational_Study_ L2 - https://doi.org/10.1007/s10552-019-01233-8 DB - PRIME DP - Unbound Medicine ER -