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Menopausal hormone use and ovarian cancer risk: individual participant meta-analysis of 52 epidemiological studies.

cam.issuedOnline2015-02-13
dc.contributor.authorCollaborative Group On Epidemiological Studies Of Ovarian Cancer
dc.contributor.authorBeral, V
dc.contributor.authorGaitskell, K
dc.contributor.authorHermon, C
dc.contributor.authorMoser, K
dc.contributor.authorReeves, G
dc.contributor.authorPeto, R
dc.date.accessioned2018-09-21T15:21:23Z
dc.date.available2018-09-21T15:21:23Z
dc.date.issued2015-05-09
dc.description.abstractBACKGROUND: Half the epidemiological studies with information about menopausal hormone therapy and ovarian cancer risk remain unpublished, and some retrospective studies could have been biased by selective participation or recall. We aimed to assess with minimal bias the effects of hormone therapy on ovarian cancer risk. METHODS: Individual participant datasets from 52 epidemiological studies were analysed centrally. The principal analyses involved the prospective studies (with last hormone therapy use extrapolated forwards for up to 4 years). Sensitivity analyses included the retrospective studies. Adjusted Poisson regressions yielded relative risks (RRs) versus never-use. FINDINGS: During prospective follow-up, 12 110 postmenopausal women, 55% (6601) of whom had used hormone therapy, developed ovarian cancer. Among women last recorded as current users, risk was increased even with <5 years of use (RR 1·43, 95% CI 1·31-1·56; p<0·0001). Combining current-or-recent use (any duration, but stopped <5 years before diagnosis) resulted in an RR of 1·37 (95% CI 1·29-1·46; p<0·0001); this risk was similar in European and American prospective studies and for oestrogen-only and oestrogen-progestagen preparations, but differed across the four main tumour types (heterogeneity p<0·0001), being definitely increased only for the two most common types, serous (RR 1·53, 95% CI 1·40-1·66; p<0·0001) and endometrioid (1·42, 1·20-1·67; p<0·0001). Risk declined the longer ago use had ceased, although about 10 years after stopping long-duration hormone therapy use there was still an excess of serous or endometrioid tumours (RR 1·25, 95% CI 1·07-1·46, p=0·005). INTERPRETATION: The increased risk may well be largely or wholly causal; if it is, women who use hormone therapy for 5 years from around age 50 years have about one extra ovarian cancer per 1000 users and, if its prognosis is typical, about one extra ovarian cancer death per 1700 users. FUNDING: Medical Research Council, Cancer Research UK.
dc.format.mediumPrint-Electronic
dc.identifier.doi10.17863/CAM.27988
dc.identifier.eissn1474-547X
dc.identifier.issn0140-6736
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/280622
dc.languageeng
dc.language.isoeng
dc.publisherElsevier BV
dc.publisher.urlhttp://dx.doi.org/10.1016/s0140-6736(14)61687-1
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectDrug Administration Schedule
dc.subjectEstrogen Replacement Therapy
dc.subjectFemale
dc.subjectHumans
dc.subjectIncidence
dc.subjectMiddle Aged
dc.subjectOvarian Neoplasms
dc.subjectPostmenopause
dc.subjectRisk Assessment
dc.titleMenopausal hormone use and ovarian cancer risk: individual participant meta-analysis of 52 epidemiological studies.
dc.typeArticle
prism.endingPage1842
prism.issueIdentifier9980
prism.publicationDate2015
prism.publicationNameLancet
prism.startingPage1835
prism.volume385
rioxxterms.licenseref.startdate2015-05
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1016/S0140-6736(14)61687-1

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