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Title
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Menopausal hormone therapy and cancer risk : an overestimated risk?
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Author
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Abstract
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| Aim: We aimed to assess the overall cancer risk among contemporary menopausal hormone therapy (MHT) users in Sweden and the risk for different cancer types. Methods: A nationwide Swedish population-based cohort study including all 290,186 women aged >= 40 years having used systemic MHT during the study period (July 2005 and December 2012), compared with the Swedish female background population. MHT ever-use (all MHT, oestrogen-only MHT [E-MHT] and oestrogen plus progestin MHT [EP-MHT]) was based on the nationwide Prescribed Drug Registry. Cancer diagnoses were grouped into 16 different anatomical locations, for which standardised incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated. Results: The SIR of any cancer was 1.09 (95% CI: 1.07-1.11) following ever MHT, 1.04 (95% CI: 1.01-1.06) for E-MHT and 1.14 (95% CI: 1.12-1.17) for EP-MHT. The highest SIR was found for EP-MHT among users aged >= 70 years (SIR = 1.33, 95% CI: 1.26-1.40). The risk for invasive breast, endometrial or ovarian cancer combined was increased for any MHT (SIR = 1.31, 95% CI: 1.28-1.34). The risk of invasive breast cancer was increased following MHT and increased with age for EP-MHT users. The risk of gastrointestinal cancers combined was decreased (SIR = 0.90, 95% CI: 0.86-0.94), particularly the oesophagus (SIR = 0.81, 95% CI: 0.64-1.00), liver (SIR = 0.81, 95% CI: 0.65-0.99) and colon (SIR = 0.90, 95% CI: 0.84-0.95). Conclusions: MHT, notably EP-MHT, was associated with a limited increase in overall cancer risk. The increased risk of female reproductive organ cancers was almost balanced by a decreased risk of gastrointestinal cancers. (C) 2017 Elsevier Ltd. All rights reserved. |
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Language
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English
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Source (journal)
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European journal of cancer. - Oxford, 1990, currens
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Publication
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Oxford
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2017
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ISSN
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0959-8049
[print]
1879-0852
[online]
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DOI
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10.1016/J.EJCA.2017.07.012
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Volume/pages
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84
(2017)
, p. 60-68
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ISI
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000411333300008
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Pubmed ID
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28783542
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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