Estrogren linked to ovarian cancer death

From, Health Watch Newsletter

Women who use postmenopausal estrogens for 10 years or more may face nearly double the normal risk of fatal ovarian cancer, according to a paper published in the Journal of the American Medical Association.

In addition, the risk may continue -- even decades years after estrogen replacement therapy is stopped.

Carmen Rodriguez, M.D., MPH, and colleagues, with the American Cancer Society, Atlanta, evaluated more than 211,000 postmenopausal women from 1982 to 1996 to examine the association between the use of postmenopausal estrogen replacement therapy (ERT) and ovarian cancer mortality.

The women studied had been enrolled in the American Cancer Society's Cancer Prevention Study II in 1982 and had no history of cancer, hysterectomy, or ovarian surgery.

A total of 46,260 (22%) of the women in the study population had used ERT, including 11,024 who were users at the start, or "baseline" of the program and 35,236 who were former users. In a 14-year period ending in 1996, 944 cancer deaths were recorded.

"In this population, postmenopausal estrogen use for 10 or more years was associated with increased risk of ovarian cancer mortality that persisted up to 29 years after cessation of use," the authors revealed.

"The risk of death was approximately doubled in women who had used estrogens for 10 or more years within the 15 years prior to enrollment," they reported. Annual age-adjusted ovarian cancer death rates per 100 000 women were 64.4 for baseline users with 10 or more years of use, 38.3 for former users with 10 or more years of use, and 26.4 for never users.

"This large prospective study supports the hypothesis that ERT increases the risk of fatal ovarian cancer. The association was related to both duration and recency of hormone use," the authors concluded.

According to background information cited in the article, postmenopausal estrogen use has already been associated with an increased risk of endometrial and breast cancer (when used for a long period).

SOURCE: "Estrogen Replacement Therapy and Ovarian Cancer Mortality in a Large Prospective Study of U.S. Women," by Carmen Rodriguez, M.D., MPH, Journal of the American Medical Association, March 21, 2001.