Skip to main content

Advertisement

Log in

Trends in hormone use and ovarian cancer incidence in US white and Australian women: implications for the future

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

To compare trends in ovarian cancer incidence in the USA and Australia in relation to changes in oral contraceptive pill (OCP) and menopausal hormone therapy (MHT) use.

Methods

US cancer incidence data (1973–2013) were accessed via SEER*Stat; Australian data (1982–2012) were accessed from the Australian Institute of Health and Welfare Cancer Incidence and Mortality books. Age-period-cohort models were constructed to assess trends in ovarian cancer incidence by birth cohort and year of diagnosis.

Results

Ovarian cancer rates were increasing until the cohorts born around 1918 in the USA and 1923 in Australia who were the first to use the OCP. They then declined dramatically across subsequent cohorts such that rates for the 1968 cohort were about half those of women born 45 years earlier; however, there are early suggestions that this decline may not continue in more recent cohorts. In contrast, despite the large reduction in MHT use, there was no convincing evidence that ovarian cancer incidence rates in either country were lower after 2002 than would have been expected based on the declining trend from 1985.

Conclusions

The major driver of ovarian cancer incidence rates appears to be the OCP. This means that when those women born since the late 1960s (who have used the OCP at high rates from an early age) reach their 60s and 70s, incidence rates are likely to stop falling and may even increase with changes in the prevalence of other factors such as tubal ligation and obesity. Forward predictions based on past trends may thus underestimate future rates and numbers of women likely to be affected.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Sources of data: a USA OCP (age 15–44 years) [5], Australia OCP use (age 15–44 years) prior to 1986 [7], Australia OCP use (estimated for age 15–44 years) from 1986 [5]. b USA [9, 10] and Australian data [11] come from different sources so the absolute values may not be directly comparable. Australian data are only available for those eligible for subsidized medications; total numbers are estimated assuming these account for 50% of all prescriptions (based on data from 2013 to 2014 when full data are available)

Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin D, Forman D, Bray F (2013) GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer. http://globocan.iarc.fr

  2. Ferlay J, Bray F, Steliarova-Foucher E, Forman D (2014) Cancer incidence in five continents, CI5plus. IARC CancerBase No. 9. Lyon: International Agency for Research on Cancer. http://ci5.iarc.fr

  3. Collaborative Group on Epidemiological Studies of Ovarian Cancer, Beral V, Doll R, Hermon C, Peto R, Reeves G (2008) Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. Lancet 371 (9609):303–314

    Article  Google Scholar 

  4. Collaborative Group on Epidemiological Studies of Ovarian Cancer, Beral V, Gaitskell K, Hermon C, Moser K, Reeves G, Peto R (2015) Menopausal hormone use and ovarian cancer risk: individual participant meta-analysis of 52 epidemiological studies. Lancet 385 (9980):1835–1842

    Article  PubMed Central  Google Scholar 

  5. United Nations Department of Economic and Social Affairs, Population Division (2015) World Contraceptive Use 2015 (POP/DB/CP/Rev2015)

  6. Sieh W, Salvador S, McGuire V, Palmieri R, Terry K, Rossing M, on behalf of the Ovarian Cancer Association Consortium et al. (2013) Tubal ligation and the risk of ovarian cancer subtypes. Int J Epidemiol 42:579–589

    Article  PubMed  PubMed Central  Google Scholar 

  7. Santow G (1991) Trends in contraception and sterilization in Australia. Aust N Z J Obstet Gynaecol 31(3):201–208

    Article  CAS  PubMed  Google Scholar 

  8. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. J Am Med Assoc 288(3):321–333

    Article  CAS  Google Scholar 

  9. Wysowski DK, Governale LA (2005) Use of menopausal hormones in the United States, 1992 through June, 2003. Pharmacoepidemiol Drug Saf 14:171–176

    Article  PubMed  Google Scholar 

  10. Stagnitti MN, Lefkowitz D (2011) Trends in hormone replacement therapy drugs utilization and expenditures for adult women in the U.S. civilian noninstitutionalized population, 2001–2008. Rockville, MD. http://www.meps.ahrq.gov/mepsweb/data_files/publications/st347/stat.pdf

  11. Canfell K, Banks E, Moa AM, Beral V (2008) Decrease in breast cancer incidence following a rapid fall in use of hormone replacement therapy in Australia. Med J Aust 188(11):641–644

    PubMed  Google Scholar 

  12. Yang HP, Anderson WF, Rosenberg PS, Trabert B, Gierach GL, Wentzensen N, Cronin KA, Sherman ME (2013) Ovarian cancer incidence trends in relation to changing patterns of menopausal hormone therapy use in the United States. J Clin Oncol 31(17):2146–2151

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Ravdin PM, Cronin KA, Howlader N et al (2007) The decrease in breast-cancer incidence in 2003 in the United States. N Engl J Med 356:1670–1674

    Article  CAS  PubMed  Google Scholar 

  14. Malvezzi M, Carioli G, Rodriguez T, Negri E, La Vecchia C (2016) Global trends and predictions in ovarian cancer mortality. Ann Oncol. doi:10.1093/annonc/mdw306

    Google Scholar 

  15. Surveillance, Epidemiology, End Results (SEER) Program (2016) SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2015 Sub (1973–2013) <Katrina/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969–2014 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2016, based on the November 2015 submission. (http://www.seer.cancer.gov)

  16. Australian Institute of Health and Welfare (AIHW) (2016) Australian cancer incidence and mortality (ACIM) books: ovarian cancer. Canberra: AIHW. http://www.aihw.gov.au/acim-books

  17. Jordan S, Wilson L, Nagle C, Green A, Olsen C, Bain C, Pandeya N, Whiteman D, Webb P (2015) Cancers in Australia in 2010 attributable to and prevented by the use of combined oral contraceptives. Aust NZ J Public Health 39:441–445

    Article  Google Scholar 

  18. Jordan S, Wilson L, Nagle C, Green A, Olsen C, Bain C, Pandeya N, Whiteman D, Webb P (2015) Cancers in Australia in 2010 attributable to and prevented by the use of menopausal hormone therapy. Aust NZ J Public Health 39:434–440

    Article  Google Scholar 

  19. Australian Bureau of Statistics (2014) Australian Historical Population Statistics (cat. no. 3105.0.65.001).

  20. United Nations, Department of Economics and Social Affairs, Population Division (2015) World population prospects: the 2015 revision, key findings and advance tables. Working paper No. ESA/P/WP.241. United Nations, New York

  21. Chan LM, Westhoff CL (2010) Tubal sterilization trends in the United States. Fertil Steril 94(1):1–6. doi:10.1016/j.fertnstert.2010.03.029

    Article  PubMed  Google Scholar 

  22. Collaborative Group on Epidemiological Studies of Ovarian Cancer (2012) Ovarian cancer and body size: individual participant meta-analysis including 25157 women with ovarian cancer from 47 epidemiological studies. PLoS Med 9(4):e1001200.

    Article  PubMed Central  Google Scholar 

  23. Olsen CM, Nagle CM, Whiteman DC, Ness R, Pearce CL, Pike MC et al (2013) Obesity and risk of ovarian cancer subtypes: evidence from the Ovarian Cancer Association Consortium. Endocr Relat Cancer 20(2):251–262. doi:10.1530/ERC-12-0395

    Article  PubMed  Google Scholar 

  24. Kendall B, Wilson L, Olsen C et al (2015) Cancers in Australia in 2010 attributable to overweight and obesity. Aust N Z J Public Health 39:452–457

    Article  PubMed  PubMed Central  Google Scholar 

  25. Nichols HB, Trentham-Dietz A, Hampton JM et al (2006) From menarche to menopause: trends among US Women born from 1912 to 1969. Am J Epidemiol 164:1003–1011

    Article  PubMed  Google Scholar 

  26. Oliphant SS, Jones KA, Wang L, Bunker CH, Lowder JL (2010) Trends over time with commonly performed obstetric and gynecologic inpatient procedures. Obstet Gynecol 116:926–931

    Article  PubMed  PubMed Central  Google Scholar 

  27. Jordan SJ, Nagle CM, Coory MD et al (2013) Has the association between hysterectomy and ovarian cancer changed over time? A systematic review and meta-analysis. Eur J Cancer 49:3638–3647

    Article  PubMed  Google Scholar 

  28. Flegal KM, Carroll MD, Ogden CL, Curtin LR (2010) Prevalence and trends in obesity among US adults, 1999–2008. J Am Med Assoc 303(3):235–241. doi:10.1001/jama.2009.2014

    Article  CAS  Google Scholar 

  29. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C et al (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384(9945):766–781. doi:10.1016/S0140-6736(14)60460-8

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

PW and SJ are funded by Research Fellowships from the National Health and Medical Research Council of Australia.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Penelope M. Webb.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 21 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Webb, P.M., Green, A.C. & Jordan, S.J. Trends in hormone use and ovarian cancer incidence in US white and Australian women: implications for the future. Cancer Causes Control 28, 365–370 (2017). https://doi.org/10.1007/s10552-017-0868-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-017-0868-0

Keywords

Navigation