Association Between Hormone Replacement Therapy and Development of Endometrial Cancer: Results From a Prospective US Cohort Study

Frontiers in Medicine

Medicine

Lingbo Qu¹  Haoyan Jiao²  Ying Liang²  Hao Liu² 

[1] Department of Chemistry, Zhengzhou University, Zhengzhou, China;Department of Pharmacy, Guangdong Food and Drug Vocational College, Guangzhou, China;

关键词: hormone replacement therapy (HRT);    endometrial cancer (EC);    body mass index;    estrogen;    progesterone;   

DOI  :  10.3389/fmed.2021.802959

 received in 2021-10-28, accepted in 2021-12-09,  发布年份 2022

来源: Frontiers

【 摘 要 】

Although hormone replacement therapy (HRT) use is associated with elevated endometrial cancer(EC) risk, little evidence assesses potential effect-modifiers on HRT-related EC in a long-term follow-up. In this large-scale longitudinal cohort study, we tried to evaluate the association between different HRT types/methods use and risk of EC, and reveal this risk within different body mass index (BMI) groups. In whole cohort, 677 EC occurred during mean 11.6 years follow-up. Cox proportional hazards regression was used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (CIs) with HRT status (never, former, or current) for risk of EC incidence. Current HRT use was not significantly associated with EC risk (HR for current vs. never HRT use: 1.13; 95% CI: 0.92, 1.38) in the whole cohort, but presented a dose-response effect on increased EC risk (HR for >10-year use vs. never HRT use: 1.73; 95% CI: 1.35, 2.21). Moreover, EC risk differed in distinct regimens or subsets (all Pinteraction < 0.05). Estrogen-only use was associated with elevated EC risk (HR for current vs. never HRT use: 1.51; 95% CI: 1.12, 2.04), but women with high BMI (> 30 kg/m2) who currently use estrogen-only harbored decreased EC risk (HR: 0.56; 95% CI: 0.38, 0.82) compared to counterparts without HRT use. Estrogen-only use is associated with increased EC risk, and precise monitoring of EC development for postmenopausal women with long-term HRT use are urgently needed. BMI could serve as an important surrogate to assess this risk.

【 授权许可】

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Copyright © 2022 Liang, Jiao, Qu and Liu.