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Combined effect of oral contraceptive use and hormone replacement therapy on breast cancer risk in postmenopausal women

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Abstract

Objective: We examined breast cancer risk related to lifetime exposure to oral contraceptives (OCs) and hormone replacement therapy (HRT) in postmenopausal women. Methods: The Women's Contraceptive and Reproductive Experiences (CARE) Study was a population-based case–control study that included 1847 postmenopausal women with incident invasive breast cancer, and 1932 control subjects, identified using random digit dialing. Results: 45% of cases and 49% of controls used both OCs and HRT. OC users were not at increased risk regardless of subsequent HRT exposure. HRT users who had used OCs previously did not have a higher risk of breast cancer than women with no exposure to OCs. We observed a negative interaction (p-value: 0.032) of combined hormone replacement therapy (CHRT) and past OC use. The increase in risk with CHRT was stronger in women who had never used OCs in the past (odds ratio: 1.05; 95% confidence interval: 1.01–1.10 per year of exclusive CHRT use) than in women who had used OCs (odds ratio: 1.00; 95% confidence interval: 0.97–1.03). Conclusions: We found no indication that adverse effects of exposure to OCs or HRT appeared only in the presence of the other hormone or were exacerbated by exposure to the other hormone.

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Author information

Author notes

  1. Linda K. Weiss

    Present address: Cancer Centers Branch, National Cancer Institute, Bethesda, MD, USA

  2. Ronald T. Burkman

    Present address: Baystate Medical Center, Department of Obstetrics and Gynecology, Springfield, MA, USA

Authors and Affiliations

  1. Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, University of Pennsylvania, 801 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA

    Sandra A. Norman

  2. Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA

    Jesse A. Berlin, Anita L. Weber & Brian L. Strom

  3. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Janet R. Daling, Lynda F. Voigt & Kathleen E. Malone

  4. Population Studies and Prevention Program, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA

    Linda K. Weiss

  5. Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA, USA

    Polly A. Marchbanks, Jill A. McDonald & Suzanne G. Folger

  6. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Leslie Bernstein, Giske Ursin & Dennis Deapen

  7. School of Public Health, Emory University, Atlanta, GA, USA

    Jonathan M. Liff

  8. Henry Ford Health Systems, Department of Obstetrics and Gynecology, Detroit, MI, USA

    Ronald T. Burkman

  9. Department of Internal Medicine, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA

    Michael S. Simon

  10. Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, GA, USA

    Phyllis A. Wingo

  11. Center for Population Research, Contraception and Reproductive Health Branch, National Institute of Child Health and Human Development, Bethesda, MD, USA

    Robert Spirtas

Authors
  1. Sandra A. Norman
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  2. Jesse A. Berlin
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  3. Anita L. Weber
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  4. Brian L. Strom
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  5. Janet R. Daling
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  6. Linda K. Weiss
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  7. Polly A. Marchbanks
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  8. Leslie Bernstein
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  9. Lynda F. Voigt
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  10. Jill A. McDonald
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  11. Giske Ursin
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  12. Jonathan M. Liff
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  13. Ronald T. Burkman
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  14. Kathleen E. Malone
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  15. Michael S. Simon
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  16. Suzanne G. Folger
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  17. Dennis Deapen
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  18. Phyllis A. Wingo
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  19. Robert Spirtas
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Corresponding author

Correspondence to Sandra A. Norman.

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Norman, S.A., Berlin, J.A., Weber, A.L. et al. Combined effect of oral contraceptive use and hormone replacement therapy on breast cancer risk in postmenopausal women. Cancer Causes Control 14, 933–943 (2003). https://doi.org/10.1023/B:CACO.0000007967.25865.29

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  • DOI: https://doi.org/10.1023/B:CACO.0000007967.25865.29

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