The Pharmaceutical Journal
Vol 268 No 7193 p487-492
13 April 2002

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Ovarian cancer risk may be limited to specific HRT

Hormone replacement therapy (HRT) with sequential rather than continuous progestogen might increase risk of ovarian cancer.

Dr Tomas Riman, department of obstetrics and gynaecology, Falu Hospital, Sweden, and colleagues conducted a case-control study to examine the relationship between HRT and ovarian cancer. A total of 655 women with ovarian cancer and 3,889 control women were asked about HRT use.

Risk of ovarian cancer was highest among women who used either estrogen-only HRT or estrogen combined with sequential progestogen. In contrast, no increased risk was seen among women who used estrogen continuously supplemented with progestogen. The odds ratios of ovarian cancer, compared with never users of HRT, were 1.58 (95 per cent confidence interval, 1.03 to 2.42) for ever users of estrogen-only HRT, 1.98 (1.40–2.78) with sequential progestogen added, and 1.11 (0.71–1.74) with continuous progestogen added. Women who had used therapy for more than 10 years were at greatest risk.

Although the reason for the increased risk of ovarian cancer is not known, the researchers suggest that it could be linked with retrograde transportation of carcinogens in menstrual bleeding (Journal of the National Cancer Institute 2002;94:497).