American Journal of Epidemiology Vol. 141, No. 9: 828-835
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health
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Estrogen Replacement Therapy and Fatal Ovarian Cancer
1Division of Epidemiology, Emory University School of Public Health Atlanta, GA
2Department of Epidemiology and Survelllance Research, American Cancer Society Atlanta, GA
Reprint requests to Dr. Carmen Rodriguez, Epidemiology and Surveillance Research, American Cancer Society, National Home Office, 1599 Clifton Rd., NE, Atlanta, GA 30329-4251.
The authors examined the relation between use of estrogen replacement therapy and ovarian cancer mortality in a large prospective mortality study of 240,073 peri- and postmenopausal women, none of whom had a prior history of cancer, hysterectomy, or ovarian surgery at enrollment in 1982. During 7 years of follow-up, 436 deaths from ovarian cancer occurred. Cox proportional hazard regression was used to adjust for other risk factors. Ever use of estrogen replacement therapy was associated with a rate ratio for fatal ovarian cancer of 1.15(95% confidence interval (Cl) 0.94–1.42). The mortality rate ratio increased with duration of use prior to entry to this study to 1.40 (95 Cl% 0.92–2.11) with 6–10 years of use and 1.71 (95% Cl 1.06–2.77) with 
11 years of use. The increase in mortality associated with 6 years of use was observed in both current users (rate ratio (RR) = 1.72, 95% Cl 1.01–2.90) and former users at study entry (RR = 1.48, 95% Cl 0.99–2.22), relative to never users. Risk associated with use was not modified by any of the other risk factors. These data suggest that long-term use of estrogen replacement therapy may increase the risk of fatal ovarian cancer. Am J Epidemiol 1995; 141:828–35.
cohort studies; estrogen replacement therapy; estrogens; ovarian neoplasms
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