Oral contraceptive use by formulation and endometrial cancer risk among women born in 1947-1964: The Nurses' Health Study II, a prospective cohort study.
Adult
Aged
Cohort Studies
Contraceptives, Oral, Hormonal
/ administration & dosage
Endometrial Neoplasms
/ chemically induced
Estrogens
/ administration & dosage
Ethinyl Estradiol
/ administration & dosage
Female
Humans
Mestranol
/ administration & dosage
Middle Aged
Progestins
/ administration & dosage
Prospective Studies
Endometrial cancer
Hormonal contraceptives
Oral contraceptives
Journal
European journal of epidemiology
ISSN: 1573-7284
Titre abrégé: Eur J Epidemiol
Pays: Netherlands
ID NLM: 8508062
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
22
09
2020
accepted:
03
12
2020
pubmed:
18
12
2020
medline:
10
9
2021
entrez:
17
12
2020
Statut:
ppublish
Résumé
Oral contraceptives (OCs) have been associated with long-term lower endometrial cancer risk; relatively little is known about associations with more recent OC formulations and associations with longer-term risk. A total of 107,069 women from the Nurses' Health Study II recalled OC use from age 13 to baseline (1989); biennial questionnaires updated data on OC use until 2009. OCs were classified by estrogen and progestin type, dose, and potency based on reported brand. 864 incident endometrial cancer cases were identified through 2017. Multivariable Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals [95% CI] for the association of OC use with endometrial cancer risk. OC use was associated with lower endometrial cancer risk (ever use, HR 0.77 [95% CI 0.65-0.91]; >10 years of use, 0.43 [0.32-0.58] vs. never OC use). Inverse associations for duration were evident regardless of time since last use. Longer durations (> 5 years) of ethinyl estradiol (0.52 [0.41-0.67]) and second-generation progestins (0.43 [0.30-0.61]), both versus never use, were more strongly associated with lower risk than mestranol (0.66 [0.50-0.88], p-het = 0.01) and first-generation progestins (0.62 [0.49-0.78], p-het = 0.03). Inverse associations were generally observed for cross-classified cumulative average estrogen and progestin dose and potency (< vs. ≥ median; ever use vs. never OC use), with the exception of high estrogen and low progestin dose. OCs were associated with lower endometrial cancer risk, independent of time since last use. Use of ethinyl estradiol and second-generation progestins were more strongly inversely associated with risk compared with older formulations.
Identifiants
pubmed: 33331993
doi: 10.1007/s10654-020-00705-5
pii: 10.1007/s10654-020-00705-5
pmc: PMC8416825
doi:
Substances chimiques
Contraceptives, Oral, Hormonal
0
Estrogens
0
Progestins
0
Ethinyl Estradiol
423D2T571U
Mestranol
B2V233XGE7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
827-839Subventions
Organisme : NCI NIH HHS
ID : P01 CA087969
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA176726
Pays : United States
Organisme : NIH HHS
ID : P01 CA87969
Pays : United States
Organisme : NIH HHS
ID : U01 CA176726
Pays : United States
Informations de copyright
© 2020. The Author(s).
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