Menopausal hormone therapy and breast cancer risk: impact of different treatments. The European Prospective Investigation into Cancer and Nutrition

被引：105

作者：

Bakken, Kjersti ^{[1
]}

Fournier, Agnes ^{[2
]}

Lund, Eiliv ^{[1
]}

Waaseth, Marit ^{[1
]}

Dumeaux, Vanessa ^{[1
]}

Clavel-Chapelon, Francoise ^{[2
]}

Fabre, Alban ^{[2
]}

Hemon, Bertrand ^{[3
]}

Rinaldi, Sabina ^{[3
]}

Chajes, Veronique ^{[3
]}

Slimani, Nadia ^{[3
]}

Allen, Naomi E. ^{[4
]}

Reeves, Gillian K. ^{[4
]}

Bingham, Sheila ^{[5
]}

Khaw, Kay-Tee ^{[5
]}

Olsen, Anja ^{[6
]}

Tjonneland, Anne ^{[6
]}

Rodriguez, Laudina ^{[7
]}

Sanchez, Maria-Jose ^{[9
]}

Amiano Etxezarreta, Pilar ^{[8
]}

Ardanaz, Eva ^{[10
]}

Tormo, Maria-Jose ^{[11
]}

Peeters, Petra H. ^{[12
]}

van Gils, Carla H. ^{[12
]}

Steffen, Annika ^{[13
]}

Schulz, Mandy ^{[13
]}

Chang-Claude, Jenny ^{[13
]}

Kaaks, Rudolf ^{[14
]}

Tumino, Rosario ^{[15
,16
]}

Gallo, Valentina ^{[17
]}

Norat, Teresa ^{[17
]}

Riboli, Elio ^{[17
]}

Panico, Salvatore ^{[18
]}

Masala, Giovanna ^{[19
]}

Gonzalez, Carlos A. ^{[20
]}

Berrino, Franco ^{[21
]}

机构：

[1] Univ Tromso, Dept Community Med, N-9037 Tromso, Norway

[2] Univ Paris, Inst Gustave Roussy, INSERM, ERI 20, Villejuif, France

[3] Int Agcy Res Canc, F-69372 Lyon, France

[4] Univ Oxford, Canc Epidemiol Unit, Oxford, England

[5] Univ Cambridge, Ctr Nutr & Canc, Dept Publ Hlth & Primary Care, Cambridge CB2 1TN, England

[6] Danish Canc Soc, Inst Canc Epidemiol, Copenhagen, Denmark

[7] Hlth & Hlth Care Serv Council, Asturias, Spain

[8] CIBERESP, Publ Hlth Div Gipuzkoa, EPIC San Sebastian, Basque Govt, Madrid, Spain

[9] Andalusian Sch Publ Hlth, Granada, Spain

[10] Publ Hlth Inst Navarra, Pamplona, Spain

[11] Murcia Reg Hlth Author, Dept Epidemiol, Murcia, Spain

[12] Univ Med Ctr, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[13] German Inst Human Nutr Rotsdam Rehbruecke, Dept Epidemiol, Nuthetal, Germany

[14] Deutsch Krebsforschungszentrum, Unit Genet Epidemiol, Div Canc Epidemiol, D-6900 Heidelberg, Germany

[15] Civile MP Arezzo Hosp, Histopathol Unit, Ragusa, Italy

[16] Civile MP Arezzo Hosp, Canc Registry, Dept Oncol, Ragusa, Italy

[17] Univ London Imperial Coll Sci Technol & Med, Div Epidemiol Publ Hlth & Primary Care, London, England

[18] Univ Naples Federico II, Dept Clin & Expt Med, Naples, Italy

[19] Canc Prevent & Res Inst ISPO, Mol & Nutr Epidemiol Unit, Florence, Italy

[20] Catalan Inst Oncol ICO, Canc Epidemiol Res Programme, Unit Nutr Environm & Canc, Barcelona, Spain

[21] Natl Canc Inst, Epidemiol Unit, I-20133 Milan, Italy

来源：

INTERNATIONAL JOURNAL OF CANCER | 2011年 / 128卷 / 01期

基金：

英国医学研究理事会;

关键词：

breast cancer; HRT; epidemiology; cohort studies; menopause; estrogens; progestins; dosage; ESTROGEN PLUS PROGESTIN; HEALTHY POSTMENOPAUSAL WOMEN; REPLACEMENT THERAPY; DECREASE; REGIMENS; COHORT; UK;

D O I：

10.1002/ijc.25314

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

Menopausal hormone therapy (MHT) is characterized by use of different constituents, regimens and routes of administration. We investigated the association between the use of different types of MHT and breast cancer risk in the EPIC cohort study. The analysis is based on data from 133,744 postmenopausal women. Approximately 133,744 postmenopausal women contributed to this analysis. Information on MHT was derived from country-specific self-administered questionnaires with a single baseline assessment. Incident breast cancers were identified through population cancer registries or by active follow-up (mean: 8.6 yr). Overall relative risks (RR) and 95% confidence interval (CI) were derived from country-specific Cox proportional hazard models estimates. A total of 4312 primary breast cancers were diagnosed during 1,153,747 person-years of follow-up. Compared with MHT never users, breast cancer risk was higher among current users of estrogen only (RR: 1.42, 95% CI 1.23-1.64) and higher still among current users of combined MHT (RR: 1.77, 95% CI 1.40-2.24; p = 0.02 for combined vs. estrogen-only). Continuous combined regimens conferred a 43% (95% CI: 19-72%) greater risk compared with sequential regimens. There was no significant difference between progesterone and testosterone derivatives in sequential regimens. There was no significant variation in risk linked to the estrogenic component of MHT, neither for oral vs. cutaneous administration nor for estradiol compounds vs. conjugated equine estrogens. Estrogen-only and combined MHT uses were associated with increased breast cancer risk. Continuous combined preparations were associated with the highest risk. Further studies are needed to disentangle the effects of the regimen and the progestin component.

引用

页码：144 / 156

页数：13

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