PMID: identifiant
de la référence Pubmed : |
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 (15856459) |
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| titre : |
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Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort. |
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| auteur(s) : |
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Agnès Fournier1, Franco Berrino2, Elio Riboli3, 4, Valérie Avenel1, Françoise Clavel-Chapelon ( ) 1, 5 |
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| laboratoire : |
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| résumé : |
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Most epidemiological studies have shown an increase in breast cancer risk related to hormone replacement therapy (HRT) use. A recent large cohort study showed effects of similar magnitude for different types of progestogens and for different routes of administration of estrogens evaluated. Further investigation of these issues is of importance. We assessed the risk of breast cancer associated with HRT use in 54,548 postmenopausal women who had never taken any HRT 1 year before entering the E3N-EPIC cohort study (mean age at inclusion: 52.8 years); 948 primary invasive breast cancers were diagnosed during follow-up (mean duration: 5.8 years). Data were analyzed using multivariate Cox proportional hazards models. In this cohort where the mean duration of HRT use was 2.8 years, an increased risk in HRT users compared to nonusers was found (relative risk (RR) 1.2 [95% confidence interval 1.1-1.4]). The RR was 1.1 [0.8-1.6] for estrogens used alone and 1.3 [1.1-1.5] when used in combination with oral progestogens. The risk was significantly greater (p <0.001) with HRT containing synthetic progestins than with HRT containing micronized progesterone, the RRs being 1.4 [1.2-1.7] and 0.9 [0.7-1.2], respectively. When combined with synthetic progestins, both oral and transdermal/percutaneous estrogens use were associated with a significantly increased risk; for transdermal/percutaneous estrogens, this was the case even when exposure was less than 2 years. Our results suggest that, when combined with synthetic progestins, even short-term use of estrogens may increase breast cancer risk. Micronized progesterone may be preferred to synthetic progestins in short-term HRT. This finding needs further investigation. |
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| domaine : |
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langue du texte
intégral : |
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Anglais |
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| ISSN : |
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0020-7136 |
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| type de publication : |
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Articles dans des revues avec comité de lecture |
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| DOI : |
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10.1002/ijc.20710 |
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| journal : |
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Int J Cancer |
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| date de publication : |
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10/04/2005 |
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| volume : |
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114 |
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| numéro : |
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3 |
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| page, identifiant, ... : |
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448-54 |
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| Descripteur(s) MeSH : |
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Adult – Aged – 80 and over – Breast Neoplasms – Drug Administration Schedule – Epidemiologic Studies – Estrogens – Female – France – Hormone Replacement Therapy – Humans – Incidence – Middle Aged – Odds Ratio – Progestins – Risk Factors – Adult – 80 and |
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| contrat, financement : |
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The E3N study is supported by grants from the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, the Institut Gustave-Roussy and the Institut National de la Santé et de la Recherche Médicale. |
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