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Hormone therapy and ovarian borderline tumors: a national cohort study

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Abstract

Purpose

Little is known about the influence of postmenopausal hormone therapy on the risk of ovarian borderline tumors. We aimed at assessing the influence of different hormone therapies on this risk.

Methods

A total of 909,875 Danish women 50–79 years old without previous hormone-sensitive cancers or bilateral oophorectomy were followed in this nationwide cohort study 1995–2005. The National Register of Medicinal Product Statistics provided exposure information on all women who redeemed prescriptions on hormone therapy. The National Cancer and Pathology Register provided data on borderline ovarian tumors. Information on confounding factors was available from other national registers. Poisson regression analyses provided risk estimates with hormone exposures as time-dependent covariates.

Results

In an average of 8.0 years of follow-up, 703 incident ovarian borderline tumors were detected. Compared with never users, hormone use for more than 4 years increased the risk of borderline tumors: relative risk (RR) 1.40; 95% confidence interval (CI), 1.09–1.81. Combined estrogen and progestin therapy for more than 4 years increased the risk: RR 1.49 (1.10–2.01), with no difference between cyclic and continuous combined therapy (p = 0.83); RR 1.56 (1.08–2.25) and 1.45 (0.87–2.43), respectively. The RR with estrogen therapy did not differ significantly from RR with combined therapy (p = 0.58): RR 1.27 (0.82–1.98). Disregarding the type of hormone therapy, hormone use for 4 years or less did not increase the risk of borderline tumors.

Conclusions

Combined hormone therapy for more than 4 years increases the risk of ovarian borderline tumors.

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Abbreviations

RR:

Relative risk

HT:

Postmenopausal hormone therapy

ET:

Estrogen-only therapy

EPT:

Estrogen/progestin therapy

DaHoRS:

Danish Sex Hormone Register Study

ATC:

Anatomical therapeutical chemical code

DDD:

Defined daily doses

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Acknowledgments

This study was supported by grant from the Danish Cancer Society. The Danish Cancer Society had no role in the design or conduct of the study.

Conflict of interest

The authors Mørch, Løkkegaard, Andreasen, and Kjær have no conflicts of interest. Lidegaard has received grants from Schering AG, Berlin, for cover of research expenses and has received fees for speeches on pharmacoepidemiological issues from Schering Denmark and Novo Nordisk.

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Authors and Affiliations

  1. Gynaecological Clinic, Copenhagen University Hospital, Copenhagen University, Section 3341, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Lina Steinrud Mørch, Susanne Krüger Kjær & Øjvind Lidegaard

  2. Gynaecological-obstetrical Department, Hillerød Hospital, Copenhagen University, Hillerød, Denmark

    Ellen Løkkegaard

  3. Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark

    Lina Steinrud Mørch & Anne Helms Andreasen

  4. Department of Virus, Hormones and Cancer, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    Susanne Krüger Kjær

Authors
  1. Lina Steinrud Mørch
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  2. Ellen Løkkegaard
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  3. Anne Helms Andreasen
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  4. Susanne Krüger Kjær
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  5. Øjvind Lidegaard
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Corresponding author

Correspondence to Lina Steinrud Mørch.

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Mørch, L.S., Løkkegaard, E., Andreasen, A.H. et al. Hormone therapy and ovarian borderline tumors: a national cohort study. Cancer Causes Control 23, 113–120 (2012). https://doi.org/10.1007/s10552-011-9860-2

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  • DOI: https://doi.org/10.1007/s10552-011-9860-2

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