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Neoplasia of the female reproductive tract

Effects of hormone therapy

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Abstract

This review presents the data on the relationship between estrogen and estrogen plus progestin therapy in postmenopausal women and the occurrence of neoplasia in the endometrium, ovary, and uterine cervix. Estrogen only in women with an intact uterus consistently is shown to increase the incidence of endometrial cancer. Estrogen plus a cyclic or sequential progestin reduces the incidence of endometrial cancer to that found in never users. The duration of the progestin administration appears to be important with less than 10 d of progestin having an increased incidence of cancer after 5 yr of therapy. Continuous estrogen plus progestin does not increase the incidence of endometrial cancer. Estrogen and estrogen plus progestin effects on the occurrence of ovarian cancer are inconsistent. The data suggest a possible increase in ovarian epithelial tumors with >10 years use of estrogen only. There is no evidence of a change in the incidence of uterine cervical neoplasia with either estrogen or progestin.

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References

  1. Yasui, T., Uemura, H., Takikawa, M., and Irahara, M. (2003). J. Med. Invest. 50, 136–145.

    PubMed  Google Scholar 

  2. Lobo, R. A., Bush, T., Carr, B. R., and Pickar, J. H. (2001). Fertil. Steril. 76, 13–24.

    Article  PubMed  CAS  Google Scholar 

  3. Lindsay, R., Gallagher, J. C., Kleerekoper, M., and Pickar, J. H. (2002). JAMA 287, 2668–2676.

    Article  PubMed  CAS  Google Scholar 

  4. Utian, W. H., Shoupe, D., Bachmann, G., Pinkerton, J. V., and Pickar, J. H. (2001). Fertil. Steril. 75, 1065–1079.

    Article  PubMed  CAS  Google Scholar 

  5. Grodstein, F., Clarkson, T. B., and Manson, J. E. (2003). N. Engl. J. Med. 348, 645–650.

    Article  PubMed  Google Scholar 

  6. Stampfer, M. J., Colditz, G. A., Willett, W. C., et al. (1991). N. Engl. J. Med. 325, 756–762.

    Article  PubMed  CAS  Google Scholar 

  7. Hadjidakis, D., Kokkinakis, E., Sfakianakis, M., and Raptis, S. A. (1999). Eur. J. Clin. Invest. 29, 877–885.

    Article  PubMed  CAS  Google Scholar 

  8. Yildiz, A., Sahin, I., Gol, K., Taner, Z., Uluturk, A., and Biberoglu, K. (1996). Int. J. Gynaecol. Obstet. 55, 153–159.

    Article  PubMed  CAS  Google Scholar 

  9. Mirkin, S., Navarro, F., and Archer, D. F. (2003). Climacteric 6, 273–277.

    PubMed  Google Scholar 

  10. Smith, D. C., Prentice, R., Thompson, D. J., and Herrmann, W. L. (1975). N. Engl. J. Med. 293, 1164–1167.

    Article  PubMed  CAS  Google Scholar 

  11. Ziel, H. K. and Finkle, W. D. (1975). N. Engl. J. Med. 293, 1167–1170.

    Article  PubMed  CAS  Google Scholar 

  12. Weiss, N. S. (1978). Ann. Intern. Med. 88, 410–412.

    PubMed  CAS  Google Scholar 

  13. Weiss, N. S., Szekely, D. R., English, D. R., and Schweid, A. I. (1979). JAMA 242, 261–264.

    Article  PubMed  CAS  Google Scholar 

  14. Hulka, B. S. (1997). Prog. Clin. Biol. Res. 396, 17–29.

    PubMed  CAS  Google Scholar 

  15. Archer, D. F. (2001). Menopause 8, 245–251.

    Article  PubMed  CAS  Google Scholar 

  16. Pickar, J. H., Thorneycroft, I., and Whitehead, M. (1998). Am. J. Obstet. Gynecol. 178, 1087–1099.

    Article  PubMed  CAS  Google Scholar 

  17. Weiderpass, E., Baron, J. A., Adami, H. O., et al. (1999). Lancet 353, 1824–1828.

    Article  PubMed  CAS  Google Scholar 

  18. Persson, I., Weiderpass, E., Bergkvist, L., Bergstrom, R., and Schairer, C. (1999). Cancer Causes Control 10, 253–260.

    Article  PubMed  CAS  Google Scholar 

  19. Beresford, S. A., Weiss, N. S., Voigt, L. F., and McKnight, B. (1997). Lancet 349, 458–461.

    Article  PubMed  CAS  Google Scholar 

  20. Woodruff, J. D. and Pickar, J. H. (1994). Am. J. Obstet. Gynecol. 170, 1213–1223.

    PubMed  CAS  Google Scholar 

  21. Pickar, J. H., Yeh, I. T., Wheeler, J. E., Cunnane, M. F., and Speroff, L. (2003). Fertil. Steril. 80, 1234–1240.

    Article  PubMed  Google Scholar 

  22. Pickar, J. H., Yeh, I., Wheeler, J. E., Cunnane, M. F., and Speroff, L. (2001). Fertil. Steril. 76, 25–31.

    Article  PubMed  CAS  Google Scholar 

  23. Staland, B. (1985). Acta Obstet. Gynecol. Scand. Suppl. 130, 29–35.

    Article  PubMed  CAS  Google Scholar 

  24. Staland, B. (1981). Maturitas 3, 145–56.

    Article  PubMed  CAS  Google Scholar 

  25. Archer, D. F., Dorin, M., Lewis, V., Schneider, D. L., and Pickar, J. H. (2001). Fertil. Steril. 75, 1080–1087.

    Article  PubMed  CAS  Google Scholar 

  26. Archer, D. F., Pickar, J. H., and Bottiglioni, F. (1994). Obstet. Gynecol. 83, 686–692.

    PubMed  CAS  Google Scholar 

  27. Simon, J. A., Liu, J. H., Speroff, L., Shumel, B. S., and Symons, J. P. (2003). Am. J. Obstet. Gynecol. 188, 92–99.

    Article  PubMed  CAS  Google Scholar 

  28. Williams, S. R., Frenchek, B., Speroff, T., and Speroff, L. (1990). Am. J. Obstet. Gynecol. 162, 438–446.

    PubMed  CAS  Google Scholar 

  29. Speroff, L., Rowan, J., Symons, J., Genant, H., and Wilborn W. (1996). JAMA 276, 1397–1403.

    Article  PubMed  CAS  Google Scholar 

  30. Symons, J., Kempfert, N., and Speroff, L. (2000). Obstet. Gynecol. 96, 366–372.

    Article  PubMed  CAS  Google Scholar 

  31. Hill, D. A., Weiss, N. S., Beresford, S. A., et al. (2000). Am. J. Obstet. Gynecol. 183, 1456–1461.

    Article  PubMed  CAS  Google Scholar 

  32. Role of progestogen in hormone therapy for postmenopausal women, position statement of The North American Menopause Society. (2003). Menopause 10, 113–132.

    Google Scholar 

  33. Kurman, R. J., Felix, J. C., Archer, D. F., Nanavati, N., Arce, J., and Moyer, D. L. (2000). Obstet. Gynecol. 96, 373–379.

    Article  PubMed  CAS  Google Scholar 

  34. Archer, D. F., Furst, K., Tipping, D., Dain, M. P., and Vandepolc C. (1999). Obstet. Gynecol. 94, 498–503.

    Article  PubMed  CAS  Google Scholar 

  35. The Writing Group for the PEPI Trial. (1996). JAMA 275, 370–375.

    Article  Google Scholar 

  36. Kurman, R. J., Kaminski, P. F., and Norris, H. J. (1985). Cancer 56, 403–412.

    Article  PubMed  CAS  Google Scholar 

  37. Ferenczy, A. and Gelfand, M. (1989). Am. J. Obstet. Gynecol. 160, 126–131.

    PubMed  CAS  Google Scholar 

  38. Austin, H., Austin, J. M. Jr., Partridge, E. E., Hatch, K. D., and Shingleton, H. M. (1991). Cancer Res. 51, 568–572.

    PubMed  CAS  Google Scholar 

  39. Deslypere, J. P. (1995). Metabolism 44, 24–27.

    Article  PubMed  CAS  Google Scholar 

  40. Purdie, D. M. and Green, A. C. (2001). Best Pract. Res. Clin. Obstet. Gynaecol. 15, 341–354.

    Article  PubMed  CAS  Google Scholar 

  41. Kaaks, R., Lukanova, A., and Kurzer, M. S. (2002). Cancer Epidemiol. Biomarkers Prev. 11, 1531–1543.

    PubMed  CAS  Google Scholar 

  42. Salazar-Martinez, E., Lazcano-Ponce, E. C., Lira-Lira, G. G., et al. (2000). Cancer Causes Control 11, 707–711.

    Article  PubMed  CAS  Google Scholar 

  43. Zendehdel, K., Nyren, O., Ostenson, C. G., Adami, H. O., Ekbom, A., and Ye, W. (2003). J. Natl. Cancer Inst. 95, 1797–1800.

    PubMed  Google Scholar 

  44. Folsom, A. R., Demissie, Z., and Harnack, L. (2003). Nutr. Cancer 46, 119–124.

    Article  PubMed  Google Scholar 

  45. Legro, R. S. (2002). Minerva Ginecol. 54, 97–114.

    PubMed  CAS  Google Scholar 

  46. Norman, R. J. and McVeigh, E. (1999). Climacteric 2, 141–143.

    PubMed  CAS  Google Scholar 

  47. Rossouw, J. E., Anderson, G. L., Prentice, R. L., et al. (2002). JAMA 288, 321–333.

    Article  PubMed  CAS  Google Scholar 

  48. Cushing, K. L., Weiss, N. S., Voigt, L. F., McKnight, B., and Beresford, S. A. (1998). Obstet. Gynecol. 91, 35–39.

    Article  PubMed  CAS  Google Scholar 

  49. Ettinger, B., Selby, J., Citron, J. T., Vangessel, A., Ettinger, V. M., and Hendrickson, M. R. (1994). Obstet. Gynecol. 83, 693–700.

    PubMed  CAS  Google Scholar 

  50. Ettinger, B., Pressman, A., and Van Gessel, A. (2001). Obstet. Gynecol. 98, 205–211.

    Article  PubMed  CAS  Google Scholar 

  51. Boerrigter, P. J., van de Weijer, P. H., Baak, J. P., Fox, H., and Haspels, A. A. (1996). Maturitas 24, 63–71.

    Article  PubMed  CAS  Google Scholar 

  52. Bjarnason, K., Cerin, A., Lindgren, R., and Weber, T. (1999). Maturitas 32, 161–170.

    Article  PubMed  CAS  Google Scholar 

  53. Cohen, L. and Fishman, D. A. (2002). Cancer Treat Res. 107, 119–132.

    PubMed  Google Scholar 

  54. NIH Consensus Development Panel on Ovarian Cancer. (1995). JAMA 273, 491–497.

    Article  Google Scholar 

  55. van Nagell, J. R. Jr., DePriest, P. D., Reedy, M. B., et al. (2000). Gynecol. Oncol. 77, 350–356.

    Article  PubMed  Google Scholar 

  56. Tailor, A., Bourne, T. H., Campbell, S., Okokon, E., Dew, T., and Collins, W. P. (2003). Ultrasound Obstet. Gynecol. 21, 378–385.

    Article  PubMed  CAS  Google Scholar 

  57. Garg, P. P., Kerlikowske, K., Subak, L., and Grady, D. (1998). Obstet. Gynecol. 92, 472–479.

    Article  PubMed  CAS  Google Scholar 

  58. Coughlin, S. S., Giustozzi, A., Smith, S. J., and Lee, N. C. (2000). J. Clin. Epidemiol. 53, 367–375.

    Article  PubMed  CAS  Google Scholar 

  59. Lacey, J. V. Jr., Mink, P. J., Lubin, J. H., et al. (2002). JAMA 288, 334–341.

    Article  PubMed  CAS  Google Scholar 

  60. Hartge, P., Hoover, R., McGowan, L., Lesher, L., and Norris, H. J. (1988). Am. J. Epidemiol. 127, 990–998.

    PubMed  CAS  Google Scholar 

  61. Riman, T., Dickman, P. W., Nilsson, S., et al. (2002). J. Natl. Cancer Inst. 94, 497–504.

    PubMed  CAS  Google Scholar 

  62. Lacey, J. V. Jr., Sherman, M. E., Hartge, P., Schatzkin, A., and Schairer, C. (2004). Int. J. Cancer 108, 281–286.

    Article  PubMed  CAS  Google Scholar 

  63. Rodriguez, C., Patel, A. V., Calle, E. E., Jacob, E. J., and Thun, M. J. (2001). JAMA 285, 1460–1465.

    Article  PubMed  CAS  Google Scholar 

  64. Persson, I., Yuen, J., Bergkvist, L., and Schairer, C. (1996). Int. J. Cancer 67, 327–332.

    Article  PubMed  CAS  Google Scholar 

  65. Smith, E. M., Johnson, S. R., Figuerres, E. J., et al. (1997). Gynecol. Oncol. 65, 441–446.

    Article  PubMed  CAS  Google Scholar 

  66. Adami, H. O., Persson, I., Hoover, R., Schairer, C., and Bergkvist, L. (1989). Int. J. Cancer 44, 833–839.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to David F. Archer.

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Archer, D.F. Neoplasia of the female reproductive tract. Endocr 24, 259–263 (2004). https://doi.org/10.1385/ENDO:24:3:259

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