Estrogen replacement therapy and ovarian cancer

Epidemiology. 2004 Jan;15(1):100-4. doi: 10.1097/01.ede.0000091606.31903.8e.


Background: A recent meta-analysis concluded that there was no overall association between estrogen replacement therapy (ERT) and risk of epithelial ovarian cancer. However, several subsequent studies have suggested that long-term ERT could increase ovarian cancer risk.

Methods: We prospectively examined the association of ERT with epithelial ovarian cancer among 31,381 postmenopausal women in Iowa followed for 15 years.

Results: Women who were using ERT at baseline had an elevated multivariate-adjusted relative risk of ovarian cancer (1.7; 95% confidence interval [CI] = 1.1-2.8) compared with never-users. Risk was higher among women who had been using ERT at baseline for more than 5 years (2.5; CI = 1.4-4.5). A time-dependent analysis likewise yielded a relative risk of 1.7 for current ERT use. Former ERT use was not associated with ovarian cancer incidence.

Conclusions: Long duration of ERT use after menopause could increase the risk of epithelial ovarian cancer.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Drug Administration Schedule
  • Estrogen Replacement Therapy / adverse effects*
  • Female
  • Humans
  • Incidence
  • Middle Aged
  • Odds Ratio
  • Ovarian Neoplasms / epidemiology*
  • Ovarian Neoplasms / etiology*
  • Postmenopause
  • Prospective Studies
  • Risk Assessment