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American Journal of Epidemiology Vol. 126, No. 5: 851-860
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health

research-article

THE INFLUENCE OF EXOGENOUS ESTROGEN USE ON SURVIVAL AFTER DIAGNOSIS OF ENDOMETRIAL CANCER

JUDITH A. SCHWARTZBAUM1,, BARBARA S. HULKA2, WESLEY C. FOWLER, JR.3, DAVID G. KAUFMAN4 and DAVID HOBERMAN5

1Department of Biostatistics and Epidemiology, Graduate School of Medical Sciences, University of Tennessee Memphis, 877 Madison Avenue, Memphis, TN 38163
2Department of Epidemiology, University of North Carolina Chapel Hill, NC
3Department of Obstetrics/Gynecology, University of North Carolina Chapel Hill. NC
4Department of Pathology, University of North Carolina Chapel Hill, NC
5Division of Biometrics Food and Drug Administration, Washington, DC

Reprint requests to Dr. Judith A. Schwartzbaum

For examination of the effect of prior exogenous estrogen use on survival after diagnosis of endometrlal cancer, 244 endometrial cancer cases newly diagnosed at North Carolina Memorial Hospital, Chapel Hill, North Carolina, between 1970 and 1976 were followed until 1982. Estrogen users (n = 46) were younger, had less advanced disease, and were more likely to be nonobese and white than were nonusers (n = 198). The estimated probability of surviving (Kaplan-Meier) five years after diagnosis was 0.89 for users and 0.53 for nonusers. When adjusted for age, grade, stage, obesity, race, and treatment (using the Cox proportional hazards regression model), the survival probabilities throughout the period of observation for estrogen users continued to be higher. The adjusted hazard rate for a nonuser was 2.05(95% confidence interval (Cl)0.96–4.39) times that for an estrogen user. The adjusted hazard rate from endometrial cancer only was 4.01 (95% Cl 1.22–13.21) times greater among estrogen nonusers. The more frequent occurrence of endometrial cancer in an earlier stage and grade among estrogen users may not be the sole cause of their lower hazard rate from this disease.

estrogens; synthetlc mortality; uterine neoplasms


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