abstract
Postmenopausal hormone therapy (HT) associates with an increased risk of
ovarian cancer,
but its'
influence on tumor histology is not as well known. Therefore,
we evaluated the effect of various types of HT on the risk of epithelial
ovarian cancer by
histological subtype. All Finnish women diagnosed with
ovarian cancer (n= 3,958)
aged over 50 during 1995-2007 were identified from the Finnish
Cancer
Registry. For each case, three controls, matched for age and place of
residence, were recruited from the Finnish National Population Register,
which also provided data on parity and ages at deliveries. After
exclusion of controls with oophorectomy, 11,325 controls remained. The
Prescription Register provided HT use from age 50. Odds ratios (OR) for
different HTs were estimated by conditional logistic regression:
adjusted for parity, ages at deliveries, and hysterectomy.
Estradiol-only therapy use for 5 years or more associated with an
increased risk (OR 1.45; 95% confidence interval 1.20-1.75) of a
serous
subtype, but with a
decreased risk of
mucinous subtype (0.35;
0.19-0.67). Use of sequential estradiol-progestin therapy (EPT) for 5
years or more associated with an increase in overall
ovarian cancer
risk (1.35; 1.20-1.63) and with an increase in the endometrioid subtype
(1.88; 1.24-2.86) particularly. Continuous EPT,
estradiol+levonorgestrel-releasing intrauterine system or tibolone had
no effect on overall
ovarian cancer risk. In conclusion, only sequential EPT use for 5 years or more associates with an increased risk of overall
ovarian cancer.
Furthermore, HT regimens differ significantly in their association with various histological types of ovarian cancer.
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