Hormone Replacement Therapy and Risks of Various Cancers in Postmenopausal Women with De Novo or a History of Endometriosis

Abstract

This study examined the impact of hormone replacement therapy (HRT) on the occurrence of various cancers in postmenopausal women with de novo or a history of endometriosis. In the datasets for ten cancers (cervical, uterine, ovarian, breast, colon, gastric, liver, lung, pancreatic, and thyroid), women who received HRT (the HRT group) and those who did not (the control group) were selected by a 1:1 matching with those who met the study criteria. In the dataset for each cancer, the incidence of each cancer was very low (0.2% to 1.5% in the HRT group and 0.2% to 1.3% in the control group). The duration of HRT was 1.3 ± 2.1 years. After adjusting for co-variables, HRT was a significant risk factor for uterine cancer (p < 0.05). However, the risk of liver cancer decreased significantly with duration of HRT (p < 0.05). Moreover, combined estrogen and progesterone decreased the risks of liver and thyroid cancers significantly (p < 0.05), and estrogen alone decreased the risks of breast and lung cancers significantly (p < 0.05). Tibolone was not associated with the risk of any of the cancers assessed. These results can help guide the use of HRT in women with de novo or a history of endometriosis.

Keywords: breast cancer; endometriosis; hormone replacement therapy; liver cancer; lung cancer; postmenopause; thyroid cancer; uterine cancer.

Figure 1

Flow chart for extracting eligible patients. The datasets for each cancer include a dataset for cervical cancer, a dataset for uterine cancer, a dataset for ovarian cancer, a dataset for breast cancer, a dataset for colon cancer, a dataset for gastric cancer, a dataset for liver cancer, a dataset for lung cancer, a dataset for pancreatic cancer, and a dataset for thyroid cancer.