Menopausal hormone therapy use and risk of ovarian cancer by race: the ovarian cancer in women of African ancestry consortium

Jessica L Petrick^#¹, Charlotte E Joslin^#^{2

3}, Courtney E Johnson⁴, T Fabian Camacho⁵, Lauren C Peres⁶, Elisa V Bandera⁷, Mollie E Barnard⁸, Alicia Beeghly⁹, Traci N Bethea¹⁰, Lauren F Dempsey⁴, Kristin Guertin¹¹, Holly R Harris^{12

13}, Patricia G Moorman¹⁴, Evan R Myers¹⁵, Heather M Ochs-Balcom¹⁶, Will Rosenow⁵, V Wendy Setiawan¹⁷, Anna H Wu¹⁷, Joellen M Schildkraut⁴, Lynn Rosenberg⁸

Affiliations

¹ Slone Epidemiology Center at Boston University, Boston, MA, USA. jpetrick@bu.edu.
² Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago School of Medicine, Chicago, IL, USA.
³ Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL, USA.
⁴ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁵ Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
⁶ Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
⁷ Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
⁸ Slone Epidemiology Center at Boston University, Boston, MA, USA.
⁹ Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA.
¹⁰ Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Campus, Washington, DC, USA.
¹¹ Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
¹² Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
¹³ Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
¹⁴ Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
¹⁵ Department of Family Medicine and Community Health, Duke University Medical Center, Durham, NC, USA.
¹⁶ Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
¹⁷ University of Southern California Norris Comprehensive Cancer Center and Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA.

^# Contributed equally.

PMID: 37865688
PMCID: PMC10703895
DOI: 10.1038/s41416-023-02407-7

Menopausal hormone therapy use and risk of ovarian cancer by race: the ovarian cancer in women of African ancestry consortium

Jessica L Petrick et al. Br J Cancer. 2023 Dec.

. 2023 Dec;129(12):1956-1967.

doi: 10.1038/s41416-023-02407-7. Epub 2023 Oct 21.

Authors

Affiliations

¹ Slone Epidemiology Center at Boston University, Boston, MA, USA. jpetrick@bu.edu.
² Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago School of Medicine, Chicago, IL, USA.
³ Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL, USA.
⁴ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁵ Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
⁶ Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
⁷ Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
⁸ Slone Epidemiology Center at Boston University, Boston, MA, USA.
⁹ Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA.
¹⁰ Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Campus, Washington, DC, USA.
¹¹ Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
¹² Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
¹³ Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
¹⁴ Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
¹⁵ Department of Family Medicine and Community Health, Duke University Medical Center, Durham, NC, USA.
¹⁶ Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
¹⁷ University of Southern California Norris Comprehensive Cancer Center and Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA.

^# Contributed equally.

PMID: 37865688
PMCID: PMC10703895
DOI: 10.1038/s41416-023-02407-7

Abstract

Background: Most studies examining post-menopausal menopausal hormone therapy (MHT) use and ovarian cancer risk have focused on White women and few have included Black women.

Methods: We evaluated MHT use and ovarian cancer risk in Black (n = 800 cases, 1783 controls) and White women (n = 2710 cases, 8556 controls), using data from the Ovarian Cancer in Women of African Ancestry consortium. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of MHT use with ovarian cancer risk, examining histotype, MHT type and duration of use.

Results: Long-term MHT use, ≥10 years, was associated with an increased ovarian cancer risk for White women (OR = 1.38, 95%CI: 1.22-1.57) and the association was consistent for Black women (OR = 1.20, 95%CI: 0.81-1.78, p_interaction = 0.4). For White women, the associations between long-term unopposed estrogen or estrogen plus progesterone use and ovarian cancer risk were similar; the increased risk associated with long-term MHT use was confined to high-grade serous and endometroid tumors. Based on smaller numbers for Black women, the increased ovarian cancer risk associated with long-term MHT use was apparent for unopposed estrogen use and was predominately confined to other epithelial histotypes.

Conclusion: The association between long-term MHT use and ovarian cancer risk was consistent for Black and White women.

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Conflict of interest statement

ME Barnard reports personal fees from Epi Excellence LLC outside of the submitted work. The remaining authors declare no competing interests.

Figures

Fig. 1. Forest plot of the study-specific odds ratios (ORs)^a and 95% confidence intervals (CIs) for the association between ≥ 10 years of menopausal hormone therapy use (compared to never use) and ovarian cancer risk by race.
^aORs are based on complete case analysis and adjusted for age at index (continuous), first degree family history of breast cancer (yes, no), first degree family history of ovarian cancer (yes, no), nulliparity (yes, no), education (high school graduate/GED or less, some college, college graduate, graduate/professional school), smoking status (ever, never), age at menopause (continuous), and pre-menopausal hysterectomy (yes, no).

See this image and copyright information in PMC

References

1. American Cancer Society. Cancer Facts & Figures. (2021).
1. National Program of Cancer Registries and Surveillance, Epidemiology and End Results Program SEER*Stat Database: NPCR and SEER Incidence - U.S. Cancer Statistics Public Use Research Database, 2020 Submission (2001-2018). United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Released June 2021. Accessed at www.cdc.gov/cancer/uscs/public-use.
1. Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER Research Data, 18 Registries, Nov 2020 Sub (2000-2018) - Linked To County Attributes - Time Dependent (1990-2018) Income/Rurality, 1969-2019 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, released April 2021, based on the November 2020 submission.
1. Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, et al. (eds). SEER Cancer Statistics Review, 1975-2012, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/archive/csr/1975_2012/, based on November 2014 SEER data submission, posted to the SEER web site, April 2015.
1. Peres LC, Cushing-Haugen KL, Kobel M, Harris HR, Berchuck A, Rossing MA, et al. Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage. J Natl Cancer Inst. 2019;111:60–68. - PMC - PubMed

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Menopausal hormone therapy use and risk of ovarian cancer by race: the ovarian cancer in women of African ancestry consortium

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Menopausal hormone therapy use and risk of ovarian cancer by race: the ovarian cancer in women of African ancestry consortium

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Abstract

Conflict of interest statement

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