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Menopausal hormone therapy and mortality among endometrial cancer patients in the NIH-AARP Diet and Health Study

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Abstract

Background

While menopausal hormone therapy (MHT) is an established endometrial cancer risk factor, its relationship with mortality among endometrial cancer patients is understudied.

Methods

Within the NIH-AARP Diet and Health Study, we examined the associations of pre-diagnosis MHT use with 10-year all-cause and endometrial cancer-specific mortality among 890 endometrial cancer patients. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) adjusted for tumor characteristics, treatment, and other risk factors.

Results

Endometrial cancer cases were diagnosed a median of 4.6 years (range 0.0–10.1 years) after the second risk factor questionnaire was completed. We identified a total of 241 deaths, of which 104 were due to endometrial cancer. Compared with non-MHT use, pre-diagnosis use of estrogen plus progestin therapy (EPT)-only was associated with lower 10-year all-cause (HR 0.65, 95 % CI 0.43–0.99, based on 29 deaths) and endometrial cancer-specific mortality (HR 0.51, 95 % CI 0.26–0.98, based on 11 deaths). Recency of MHT use, assessed approximately 5 years prior to the endometrial cancer diagnosis, was associated with mortality. Compared with non-MHT users, former ET users had higher all-cause (HR 1.71, 95 % CI 1.02–2.88, based on 18 deaths) and endometrial cancer-specific mortality (HR 2.17, 95 % CI 0.96–4.90, based on 8 deaths), whereas current EPT users had nonsignificant lower risks of death.

Conclusion

Based on small numbers, we observed that pre-diagnosis use of EPT was related to lower mortality among endometrial cancer patients. Future studies examining the biological mechanisms underlying this association are warranted.

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Acknowledgments

This research was supported (in part) by the Intramural Research Program of the National Cancer Institute.

Conflict of interest

The authors declare that there are no conflicts of interest.

Author information

Author notes

  1. Yikyung Park

    Present address: Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USA

Authors and Affiliations

  1. Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 7E214, Bethesda, MD, 20892-9774, USA

    Ashley S. Felix, Britton Trabert, Gretchen L. Gierach & Louise A. Brinton

  2. Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9774, USA

    Ashley S. Felix

  3. Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9774, USA

    Hannah Arem & Yikyung Park

  4. Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9774, USA

    Ruth M. Pfeiffer

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  1. Ashley S. Felix
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  2. Hannah Arem
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  7. Louise A. Brinton
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Corresponding author

Correspondence to Ashley S. Felix.

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Felix, A.S., Arem, H., Trabert, B. et al. Menopausal hormone therapy and mortality among endometrial cancer patients in the NIH-AARP Diet and Health Study. Cancer Causes Control 26, 1055–1063 (2015). https://doi.org/10.1007/s10552-015-0598-0

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  • DOI: https://doi.org/10.1007/s10552-015-0598-0

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