Postmenopausal Hormone Replacement Therapy and Gynecological Malignancies

  • Peter Kenemans
  • Curt W. Burger
  • Fedde Scheele
Part of the Medical Science Symposia Series book series (MSSS, volume 13)


Postmenopausal use of sex hormones (HRT) carries benefits as well as risks [1]. Both for unopposed estrogen use (ERT) in hysterectomized women as well as for combined estrogen-progestagen use (EPRT), the risk-benefit equation points to an overall benefit, with a calculable gain in postmenopausal years [2] and an actually demonstrated reduced mortality among women taking hormones [3–6].


Endometrial Cancer Hormone Replacement Therapy Human Papilloma Virus Epithelial Ovarian Cancer Endometrial Carcinoma 
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  1. 1.
    Crosignani PG, Kenemans P, Paoletti R, Soma MR, Woodford FP. Hormone replacement and the menopause: A European position paper. Eur J Obstet Gynecol Reprod Biol 1997;74:67–72.PubMedCrossRefGoogle Scholar
  2. 2.
    Grady D, Rubin SM, Petitti DB, et al. Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med 1992;117:1016–37.PubMedGoogle Scholar
  3. 3.
    Bush TL, Cowan LD, Barrett-Connor E, et al. Estrogen use and all-cause mortality: Preliminary results from the Lipid Research Clinics Program Follow-Up Study. JAMA 1983;294:903–6.CrossRefGoogle Scholar
  4. 4.
    Henderson BE, Paganini-Hill A, Ross RK. Decreased mortality in users of estrogen replacement therapy. Arch Intern Med 1991;151:75–78.PubMedCrossRefGoogle Scholar
  5. 5.
    Ettinger B, Friedman GD, Bush T, Quesenberry Jr CP. Reduced mortality associated with long-term postmenopausal estrogen therapy. Obstet Gynecol 1996;87:6–12.PubMedCrossRefGoogle Scholar
  6. 6.
    Grodstein F, Stampfer M, Colditz GA, et al. Postmenopausal hormone replacement therapy and mortality. New Engl J Med 1997;336.25;1769–75CrossRefGoogle Scholar
  7. 7.
    Grady D, Gebretsadik T, Kerlikowke K, Ernster V, Petitti D. Hormone replacement therapy and endometrial cancer risk: A meta-analysis. Obstet Gynecol 1995;85:304–13.PubMedCrossRefGoogle Scholar
  8. 8.
    Ziel HK, Finkle WD. Increased risk of endometrial carcinoma among users of conjugated estrogens. N Eng] J Med 1975;293:1167–70.CrossRefGoogle Scholar
  9. 9.
    Smith DC, Prentice R, Thompson DJ, Herrmann WL. Association of exogenous estrogen and endometrial carcinoma. N Engl J Med 1975;293:1164–67.PubMedCrossRefGoogle Scholar
  10. 10.
    Green PK, Weiss NS, McKnight B, Voigt LF, Beresford SAA. Risk of endometrial cancer following cessation of menopausal hormone use (Washington, United States). Cancer Causes and Control 1996;7:575–80.PubMedCrossRefGoogle Scholar
  11. 11.
    Beresford SAA, Weiss NS, Voigt LF, B McKnight B. Risk of endometrial cancer in relation to estrogen combined with cyclic progestogen therapy in postmenopausal women. Lancet 1997;349:458–61.PubMedCrossRefGoogle Scholar
  12. 12.
    Persson I, J Yuen J, Bergkvist L, Schairer C. Cancer incidence and mortality in women receiving estrogen and estrogen-progestin replacement therapy — long-term follow-up of a Swedish cohort. Int J Cancer 1996;67:327–32.PubMedCrossRefGoogle Scholar
  13. 13.
    Paganini-Hill A, Ross RK, Henderson BE. Endometrial cancer and patterns of use of oestrogen replacement therapy: A cohort study. Br J Cancer 1989;59:445–47.PubMedGoogle Scholar
  14. 14.
    Ettinger B, Golditch IM, Friedman G. Gynecologic consequences of long-term, unopposed estrogen replacement therapy. Maturitas 1988;10:271–80.PubMedCrossRefGoogle Scholar
  15. 15.
    Pike MC, Peters RK, Cozen W, Probst-Hensch NM, Felix JC, Wan PC, Mack TM. Estrogen-progestin replacement therapy and endometrial cancer. J Natl Cancer Inst 1997;89:1110–16.PubMedCrossRefGoogle Scholar
  16. 16.
    Ziel HK, Finkle WD, Greenland S. Decline in incidence of endometrial cancer following increase in prescriptions for opposed conjugated estrogens in a prepaid health plan. Gynecol Oncol 1998;68:253–55.PubMedCrossRefGoogle Scholar
  17. 17.
    Voigt LF, Weiss NS, Chu J, Daling JR, McKnight B, Belle G van. Progestogen supplementation of exogenous oestrogens and risk of endometrial cancer. Lancet 1991;338:274–77.PubMedCrossRefGoogle Scholar
  18. 18.
    Brinton LA, Hoover RN. Estrogen replacement therapy and endometrial cancer risk: Unresolved Issues. Obstet Gynecol 1993;81:265–71.PubMedGoogle Scholar
  19. 19.
    Comerci JT, Goldberg GL, Runowicz CD, Fields AL. Continuous low-dose combined hormone replacement therapy and the risk of endometrial cancer. Gynecol Oncol 1997;64:425–30.PubMedCrossRefGoogle Scholar
  20. 20.
    Burger CW, Bouwma AE, Stellingwerff GC, Kenemans P. “De pil” en kanker van de vrouwelijke geslachtsorganen en de mamma. Ned T Geneeskd 1994;138:16–21.Google Scholar
  21. 21.
    Booth M, Beral V, Smith P. Risk factors for ovarian cancer: A case-control study. Br J Cancer 1989;60:592–98.PubMedGoogle Scholar
  22. 22.
    Kaufman DW, Kelly JP, Welch WR, et al. Noncontraceptive estrogen use of epithelial ovarian cancer. Am J Epidemiol 1989:13-0:1142–51.Google Scholar
  23. 23.
    Whittemore AS, Harris R, Itnyre J, the Collaborative Ovarian Cancer Group. Characteristics relating to ovarian cancer risk: Collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. Am J Epidemiol 1992;136:1184–1203.PubMedGoogle Scholar
  24. 24.
    Risch HA. Estrogen replacement therapy and risk of epithelial ovarian cancer. Gynecol Oncol 1996;63:254–57.PubMedCrossRefGoogle Scholar
  25. 25.
    Rodriguez C, Calle EE, Coates RJ, Miracle-McMahill HL, Thun MJ, Heath CW. Estrogen replacement therapy and fatal ovarian cancer. Am J Epidemiol 1995;141:828–35.PubMedGoogle Scholar
  26. 26.
    Hempling RE, Wong C, Piver MS, Natarajan N, Mettlin CJ. Hormone replace therapy as a risk factor for epithelial ovarian cancer: Results of a case-control study. Obstet Gynecol 1997;89:1012–16.PubMedCrossRefGoogle Scholar
  27. 27.
    Remmink AJ, Walboomers JJM, Heimerhorst ThJM, et al. The presence of persistent high-risk HPV genotypes in dysplastic cervical lesions is associated with progressive disease: Natural history up to 36 months. Int J Cancer 1995;61:306–11.PubMedCrossRefGoogle Scholar
  28. 28.
    Smith EM, Turek LP, Haugen TH, Fedderson D, Mendoza M, Figuerres EJ, Johnson SR. The frequency of human papillomavirus detection in postmenopausal women on hormone replacement therapy. Gynecol Oncol 1997;65:441–46.PubMedCrossRefGoogle Scholar
  29. 29.
    Ferenczy A, Mansour N, Franco E, Gelfand MM. Human papillomavirus infection in postmenopausal women with and without hormone therapy. Obstet Gynecol 1997;90:7–11.PubMedCrossRefGoogle Scholar
  30. 30.
    Hunt K, Vessey M, McPherson K, Coleman M. Long-term surveillance of mortality and cancer incidence in women receiving hormone replacement therapy. Br J Obstet Gynaecol 1987;94:620–35.PubMedGoogle Scholar
  31. 31.
    Newcomb PA, Weiss NS, Daling JR. Incidence of vulvar carcinoma in relation to menstrual, reproductive and medical factors. JNCI 1984;73:391–96.PubMedGoogle Scholar
  32. 32.
    Brinton LA, Nasca PC, Mallin K, et al. Case-control study of cancer of the vulva. Obstet Gynecol 1990;75:859–66.PubMedGoogle Scholar
  33. 33.
    Sherman KJ, Daling JR, McKnight B, Chu J. Hormonal factors in vulvar cancer. A case-control study. J Reprod Med 1994;39:857–61.PubMedGoogle Scholar
  34. 34.
    Altéras MM, Jaffe R, Cohen I, et al. Role of prolonged excessive estrogen stimulation in the pathogenesis of endometrial sarcomas: Two cases and a review of the literature. Gynecol Oncol 1990;38:273–77.CrossRefGoogle Scholar
  35. 35.
    Calle EE, Miracle-McMahill HL, Thun MJ, Heath Jr CW. Estrogen replacement therapy and risk of fatal colon cancer in a prospective cohort of postmenopausal women. J Natl Cancer Inst 1995;87:517–23.PubMedCrossRefGoogle Scholar
  36. 36.
    Newcomb PA, Storer BE. Postmenopausal hormone use and risk of large-bowel cancer. J Natl Cancer Inst 1995;87:1067–71.PubMedCrossRefGoogle Scholar
  37. 37.
    Kenemans P, Stampfer M. Hormone replacement therapy and breast cancer. Eur J Obstet Gynecol Reprod Biol 1996;67:1–4.PubMedCrossRefGoogle Scholar
  38. 38.
    Kenemans P, Scheele F, Burger CW. Hormone replacement therapy and breast cancer morbidity, mortality and recurrence. Eur J Obstet Gynecol Reprod Biol 1997;71:199–203.PubMedCrossRefGoogle Scholar
  39. 39.
    Sismondi P, Biblia N, Giai M, Ponzone R, Campagnoli C. Hormone replacement therapy and breast and gynecologic cancers. In: Paoletti R, Crosignani P, Kenemans P, Samsioe G, Soma MR, Jacksonv AS, editors. Women’s health and menopause: Risk reduction strategies. Dordrecht, The Netherlands: Kluwer Academic Press, 1997:303–13.Google Scholar
  40. 40.
    Burger CW, Kenemans P. Postmenopausal hormone replacement therapy and cancer of the female genital tract and the breast. Curr Opin Obstet Gynecol 1998;10:41–45.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers and Fondazione Giovanni Lorenzini 1999

Authors and Affiliations

  • Peter Kenemans
  • Curt W. Burger
  • Fedde Scheele

There are no affiliations available

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