Endometriosis and menopausal hormone therapy impact the hysterectomy-ovarian cancer association

Lilah Khoja; Rachel Palmieri Weber; Penelope M Webb; Susan J Jordan; Aruna Muthukumar; Jenny Chang-Claude; Renée T Fortner; Allan Jensen; Susanne K Kjaer; Harvey Risch; Jennifer Anne Doherty; Holly R Harris; Marc T Goodman; Francesmary Modugno; Kirsten Moysich; Andrew Berchuck; Joellen M Schildkraut; Daniel Cramer; Kathryn L Terry; Hoda Anton-Culver; Argyrios Ziogas; Minh Tung Phung; Gillian E Hanley; Anna H Wu; Bhramar Mukherjee; Karen McLean; Kathleen Cho; Malcolm C Pike; Celeste Leigh Pearce; Alice W Lee; Australian Ovarian Cancer Study Group

doi:10.1016/j.ygyno.2021.10.088

Endometriosis and menopausal hormone therapy impact the hysterectomy-ovarian cancer association

Lilah Khoja, Rachel Palmieri Weber, Penelope M Webb, Susan J Jordan, Aruna Muthukumar, Jenny Chang-Claude, Renée T Fortner, Allan Jensen, Susanne K Kjaer, Harvey Risch, Jennifer Anne Doherty, Holly R Harris, Marc T Goodman, Francesmary Modugno, Kirsten Moysich, Andrew Berchuck, Joellen M Schildkraut, Daniel Cramer, Kathryn L Terry, Hoda Anton-CulverArgyrios Ziogas, Minh Tung Phung, Gillian E Hanley, Anna H Wu, Bhramar Mukherjee, Karen McLean, Kathleen Cho, Malcolm C Pike, Celeste Leigh Pearce, Alice W Lee, Australian Ovarian Cancer Study Group

13 Citationer (Scopus)

Abstract

OBJECTIVE: To evaluate the association between hysterectomy and ovarian cancer, and to understand how hormone therapy (HT) use and endometriosis affect this association.

METHODS: We conducted a pooled analysis of self-reported data from 11 case-control studies in the Ovarian Cancer Association Consortium (OCAC). Women with (n = 5350) and without ovarian cancer (n = 7544) who never used HT or exclusively used either estrogen-only therapy (ET) or estrogen+progestin therapy (EPT) were included. Risk of invasive epithelial ovarian cancer adjusted for duration of ET and EPT use and stratified on history of endometriosis was determined using odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Overall and among women without endometriosis, there was a positive association between ovarian cancer risk and hysterectomy (OR = 1.19, 95% CI 1.09-1.31 and OR = 1.20, 95% CI 1.09-1.32, respectively), but no association upon adjusting for duration of ET and EPT use (OR = 1.04, 95% CI 0.94-1.16 and OR = 1.06, 95% CI 0.95-1.18, respectively). Among women with a history of endometriosis, there was a slight inverse association between hysterectomy and ovarian cancer risk (OR = 0.93, 95% CI 0.69-1.26), but this association became stronger and statistically significant after adjusting for duration of ET and EPT use (OR = 0.69, 95% CI 0.48-0.99).

CONCLUSIONS: The hysterectomy-ovarian cancer association is complex and cannot be understood without considering duration of ET and EPT use and history of endometriosis. Failure to take these exposures into account in prior studies casts doubt on their conclusions. Overall, hysterectomy is not risk-reducing for ovarian cancer, however the inverse association among women with endometriosis warrants further investigation.

Originalsprog	Engelsk
Tidsskrift	Gynecologic Oncology
Vol/bind	164
Udgave nummer	1
Sider (fra-til)	195-201
Antal sider	7
ISSN	0090-8258
DOI	https://doi.org/10.1016/j.ygyno.2021.10.088
Status	Udgivet - jan. 2022

Adgang til dokumentet

10.1016/j.ygyno.2021.10.088

Andre filer og links

Link to publication in Scopus

Citationsformater

Khoja, L., Weber, R. P., Webb, P. M., Jordan, S. J., Muthukumar, A., Chang-Claude, J., Fortner, R. T., Jensen, A., Kjaer, S. K., Risch, H., Doherty, J. A., Harris, H. R., Goodman, M. T., Modugno, F., Moysich, K., Berchuck, A., Schildkraut, J. M., Cramer, D., Terry, K. L., ... Australian Ovarian Cancer Study Group (2022). Endometriosis and menopausal hormone therapy impact the hysterectomy-ovarian cancer association. Gynecologic Oncology, 164(1), 195-201. https://doi.org/10.1016/j.ygyno.2021.10.088

Khoja, L, Weber, RP, Webb, PM, Jordan, SJ, Muthukumar, A, Chang-Claude, J, Fortner, RT, Jensen, A, Kjaer, SK, Risch, H, Doherty, JA, Harris, HR, Goodman, MT, Modugno, F, Moysich, K, Berchuck, A, Schildkraut, JM, Cramer, D, Terry, KL, Anton-Culver, H, Ziogas, A, Phung, MT, Hanley, GE, Wu, AH, Mukherjee, B, McLean, K, Cho, K, Pike, MC, Pearce, CL, Lee, AW & Australian Ovarian Cancer Study Group 2022, 'Endometriosis and menopausal hormone therapy impact the hysterectomy-ovarian cancer association', Gynecologic Oncology, bind 164, nr. 1, s. 195-201. https://doi.org/10.1016/j.ygyno.2021.10.088

@article{115c0c1deb4b4fef935d6bed0493f0c4,

title = "Endometriosis and menopausal hormone therapy impact the hysterectomy-ovarian cancer association",

abstract = "OBJECTIVE: To evaluate the association between hysterectomy and ovarian cancer, and to understand how hormone therapy (HT) use and endometriosis affect this association.METHODS: We conducted a pooled analysis of self-reported data from 11 case-control studies in the Ovarian Cancer Association Consortium (OCAC). Women with (n = 5350) and without ovarian cancer (n = 7544) who never used HT or exclusively used either estrogen-only therapy (ET) or estrogen+progestin therapy (EPT) were included. Risk of invasive epithelial ovarian cancer adjusted for duration of ET and EPT use and stratified on history of endometriosis was determined using odds ratios (ORs) with 95% confidence intervals (CIs).RESULTS: Overall and among women without endometriosis, there was a positive association between ovarian cancer risk and hysterectomy (OR = 1.19, 95% CI 1.09-1.31 and OR = 1.20, 95% CI 1.09-1.32, respectively), but no association upon adjusting for duration of ET and EPT use (OR = 1.04, 95% CI 0.94-1.16 and OR = 1.06, 95% CI 0.95-1.18, respectively). Among women with a history of endometriosis, there was a slight inverse association between hysterectomy and ovarian cancer risk (OR = 0.93, 95% CI 0.69-1.26), but this association became stronger and statistically significant after adjusting for duration of ET and EPT use (OR = 0.69, 95% CI 0.48-0.99).CONCLUSIONS: The hysterectomy-ovarian cancer association is complex and cannot be understood without considering duration of ET and EPT use and history of endometriosis. Failure to take these exposures into account in prior studies casts doubt on their conclusions. Overall, hysterectomy is not risk-reducing for ovarian cancer, however the inverse association among women with endometriosis warrants further investigation.",

author = "Lilah Khoja and Weber, {Rachel Palmieri} and Webb, {Penelope M} and Jordan, {Susan J} and Aruna Muthukumar and Jenny Chang-Claude and Fortner, {Ren{\'e}e T} and Allan Jensen and Kjaer, {Susanne K} and Harvey Risch and Doherty, {Jennifer Anne} and Harris, {Holly R} and Goodman, {Marc T} and Francesmary Modugno and Kirsten Moysich and Andrew Berchuck and Schildkraut, {Joellen M} and Daniel Cramer and Terry, {Kathryn L} and Hoda Anton-Culver and Argyrios Ziogas and Phung, {Minh Tung} and Hanley, {Gillian E} and Wu, {Anna H} and Bhramar Mukherjee and Karen McLean and Kathleen Cho and Pike, {Malcolm C} and Pearce, {Celeste Leigh} and Lee, {Alice W} and {Australian Ovarian Cancer Study Group}",

note = "Copyright {\textcopyright} 2021. Published by Elsevier Inc.",

year = "2022",

month = jan,

doi = "10.1016/j.ygyno.2021.10.088",

language = "English",

volume = "164",

pages = "195--201",

journal = "Gynecologic Oncology",

issn = "0090-8258",

publisher = "Academic Press Inc.",

number = "1",

}

TY - JOUR

T1 - Endometriosis and menopausal hormone therapy impact the hysterectomy-ovarian cancer association

AU - Khoja, Lilah

AU - Weber, Rachel Palmieri

AU - Webb, Penelope M

AU - Jordan, Susan J

AU - Muthukumar, Aruna

AU - Chang-Claude, Jenny

AU - Fortner, Renée T

AU - Jensen, Allan

AU - Kjaer, Susanne K

AU - Risch, Harvey

AU - Doherty, Jennifer Anne

AU - Harris, Holly R

AU - Goodman, Marc T

AU - Modugno, Francesmary

AU - Moysich, Kirsten

AU - Berchuck, Andrew

AU - Schildkraut, Joellen M

AU - Cramer, Daniel

AU - Terry, Kathryn L

AU - Anton-Culver, Hoda

AU - Ziogas, Argyrios

AU - Phung, Minh Tung

AU - Hanley, Gillian E

AU - Wu, Anna H

AU - Mukherjee, Bhramar

AU - McLean, Karen

AU - Cho, Kathleen

AU - Pike, Malcolm C

AU - Pearce, Celeste Leigh

AU - Lee, Alice W

AU - Australian Ovarian Cancer Study Group

PY - 2022/1

Y1 - 2022/1

N2 - OBJECTIVE: To evaluate the association between hysterectomy and ovarian cancer, and to understand how hormone therapy (HT) use and endometriosis affect this association.METHODS: We conducted a pooled analysis of self-reported data from 11 case-control studies in the Ovarian Cancer Association Consortium (OCAC). Women with (n = 5350) and without ovarian cancer (n = 7544) who never used HT or exclusively used either estrogen-only therapy (ET) or estrogen+progestin therapy (EPT) were included. Risk of invasive epithelial ovarian cancer adjusted for duration of ET and EPT use and stratified on history of endometriosis was determined using odds ratios (ORs) with 95% confidence intervals (CIs).RESULTS: Overall and among women without endometriosis, there was a positive association between ovarian cancer risk and hysterectomy (OR = 1.19, 95% CI 1.09-1.31 and OR = 1.20, 95% CI 1.09-1.32, respectively), but no association upon adjusting for duration of ET and EPT use (OR = 1.04, 95% CI 0.94-1.16 and OR = 1.06, 95% CI 0.95-1.18, respectively). Among women with a history of endometriosis, there was a slight inverse association between hysterectomy and ovarian cancer risk (OR = 0.93, 95% CI 0.69-1.26), but this association became stronger and statistically significant after adjusting for duration of ET and EPT use (OR = 0.69, 95% CI 0.48-0.99).CONCLUSIONS: The hysterectomy-ovarian cancer association is complex and cannot be understood without considering duration of ET and EPT use and history of endometriosis. Failure to take these exposures into account in prior studies casts doubt on their conclusions. Overall, hysterectomy is not risk-reducing for ovarian cancer, however the inverse association among women with endometriosis warrants further investigation.

AB - OBJECTIVE: To evaluate the association between hysterectomy and ovarian cancer, and to understand how hormone therapy (HT) use and endometriosis affect this association.METHODS: We conducted a pooled analysis of self-reported data from 11 case-control studies in the Ovarian Cancer Association Consortium (OCAC). Women with (n = 5350) and without ovarian cancer (n = 7544) who never used HT or exclusively used either estrogen-only therapy (ET) or estrogen+progestin therapy (EPT) were included. Risk of invasive epithelial ovarian cancer adjusted for duration of ET and EPT use and stratified on history of endometriosis was determined using odds ratios (ORs) with 95% confidence intervals (CIs).RESULTS: Overall and among women without endometriosis, there was a positive association between ovarian cancer risk and hysterectomy (OR = 1.19, 95% CI 1.09-1.31 and OR = 1.20, 95% CI 1.09-1.32, respectively), but no association upon adjusting for duration of ET and EPT use (OR = 1.04, 95% CI 0.94-1.16 and OR = 1.06, 95% CI 0.95-1.18, respectively). Among women with a history of endometriosis, there was a slight inverse association between hysterectomy and ovarian cancer risk (OR = 0.93, 95% CI 0.69-1.26), but this association became stronger and statistically significant after adjusting for duration of ET and EPT use (OR = 0.69, 95% CI 0.48-0.99).CONCLUSIONS: The hysterectomy-ovarian cancer association is complex and cannot be understood without considering duration of ET and EPT use and history of endometriosis. Failure to take these exposures into account in prior studies casts doubt on their conclusions. Overall, hysterectomy is not risk-reducing for ovarian cancer, however the inverse association among women with endometriosis warrants further investigation.

UR - http://www.scopus.com/inward/record.url?scp=85119056083&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2021.10.088

DO - 10.1016/j.ygyno.2021.10.088

M3 - Journal article

C2 - 34776242

SN - 0090-8258

VL - 164

SP - 195

EP - 201

JO - Gynecologic Oncology

JF - Gynecologic Oncology

IS - 1

ER -

Endometriosis and menopausal hormone therapy impact the hysterectomy-ovarian cancer association

Abstract

Adgang til dokumentet

Andre filer og links

Fingeraftryk

Citationsformater