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Menopausal hormone therapy use and risk of ovarian cancer by race: the ovarian cancer in women of African ancestry consortium

British Journal of Cancer volume 129, pages 1956–1967 (2023)Cite this article

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Abstract

Background

Most studies examining post-menopausal menopausal hormone therapy (MHT) use and ovarian cancer risk have focused on White women and few have included Black women.

Methods

We evaluated MHT use and ovarian cancer risk in Black (n = 800 cases, 1783 controls) and White women (n = 2710 cases, 8556 controls), using data from the Ovarian Cancer in Women of African Ancestry consortium. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of MHT use with ovarian cancer risk, examining histotype, MHT type and duration of use.

Results

Long-term MHT use, ≥10 years, was associated with an increased ovarian cancer risk for White women (OR = 1.38, 95%CI: 1.22–1.57) and the association was consistent for Black women (OR = 1.20, 95%CI: 0.81–1.78, pinteraction = 0.4). For White women, the associations between long-term unopposed estrogen or estrogen plus progesterone use and ovarian cancer risk were similar; the increased risk associated with long-term MHT use was confined to high-grade serous and endometroid tumors. Based on smaller numbers for Black women, the increased ovarian cancer risk associated with long-term MHT use was apparent for unopposed estrogen use and was predominately confined to other epithelial histotypes.

Conclusion

The association between long-term MHT use and ovarian cancer risk was consistent for Black and White women.

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Fig. 1: Forest plot of the study-specific odds ratios (ORs)a and 95% confidence intervals (CIs) for the association between ≥ 10 years of menopausal hormone therapy use (compared to never use) and ovarian cancer risk by race.

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Data availability

The data underlying this article will be shared on reasonable request to the OCWAA Consortium.

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Acknowledgements

The authors thank the WHI investigators and staff for their dedication, and the study participants for making the study possible. A full listing of WHI investigators can be found at: https://www.whi.org/doc/WHI-Investigator-Long-List.pdf. Pathology data were obtained from the following state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA), and results reported do not necessarily represent their views. The IRBs of participating institutions and cancer registries have approved these studies, as required. Opinions expressed by the authors are their own and this material should not be interpreted as representing the official viewpoint of the U.S. Department of Health and Human Services, the National Institutes of Health, or the National Cancer Institute.

Funding

The OCWAA Consortium is funded by the National Cancer Institute (R01CA207260), and the individual studies in the OCWAA Consortium received funding from several Institutes in the National Institutes of Health: R01CA142081 for AACES; R01CA058420, UM1CA164974, U01CA164974 for BWHS; P60MD003424 for CCCCS; N01CN025403, P01CA17054, P30CA14089, R01CA61132, N01PC67010, R03CA113148, R03CA115195 for LACOCS; U01CA164973 for MEC; and R01CA76016 for NCOCS. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201600001C, HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C. Peres and Bethea are additionally supported by the National Cancer Institute (R00 CA218681 (Peres); K01 CA212056 (Bethea)); Petrick is supported by the Karin Grunebaum Cancer Research Foundation and the Boston University Peter Paul Career Development Professorship. The funders did not play a role in the design of the study; the collection, analysis, and interpretation of the data; the writing of the manuscript; and the decision to submit the manuscript for publication.

Author information

Author notes

  1. These authors contributed equally: Jessica L. Petrick, Charlotte E. Joslin.

  2. These authors jointly supervised this work: Joellen M. Schildkraut, Lynn Rosenberg.

Authors and Affiliations

  1. Slone Epidemiology Center at Boston University, Boston, MA, USA

    Jessica L. Petrick, Mollie E. Barnard & Lynn Rosenberg

  2. Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago School of Medicine, Chicago, IL, USA

    Charlotte E. Joslin

  3. Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL, USA

    Charlotte E. Joslin

  4. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Courtney E. Johnson, Lauren F. Dempsey & Joellen M. Schildkraut

  5. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA

    T. Fabian Camacho & Will Rosenow

  6. Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Lauren C. Peres

  7. Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    Elisa V. Bandera

  8. Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA

    Alicia Beeghly

  9. Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Campus, Washington, DC, USA

    Traci N. Bethea

  10. Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA

    Kristin Guertin

  11. Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Holly R. Harris

  12. Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA

    Holly R. Harris

  13. Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA

    Patricia G. Moorman

  14. Department of Family Medicine and Community Health, Duke University Medical Center, Durham, NC, USA

    Evan R. Myers

  15. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA

    Heather M. Ochs-Balcom

  16. University of Southern California Norris Comprehensive Cancer Center and Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA

    V. Wendy Setiawan & Anna H. Wu

Authors
  1. Jessica L. Petrick
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Contributions

Conceptualization: JMS, LR, CEJ, LCP, JLP. Data curation: CEJ, EVB, TNB, ABF, HRH, PGM, EM, HMO, VWS, AHW, LR, JMS. Formal Analysis: CEJ, TFC, WR. Funding acquisition: JMS, LR. Methodology: JMS, LR, CEJ, LCP, MEB, JLP. Critical revision and interpterion: All authors. Writing – original draft: JLP, LR. Writing – critical revision & editing: All authors. Approval of final manuscript: All authors.

Corresponding author

Correspondence to Jessica L. Petrick.

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ME Barnard reports personal fees from Epi Excellence LLC outside of the submitted work. The remaining authors declare no competing interests.

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Each study obtained informed consent from its participants; the individual studies and the OCWAA Consortium were approved by the relevant Institutional Review Boards.

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Petrick, J.L., Joslin, C.E., Johnson, C.E. et al. Menopausal hormone therapy use and risk of ovarian cancer by race: the ovarian cancer in women of African ancestry consortium. Br J Cancer 129, 1956–1967 (2023). https://doi.org/10.1038/s41416-023-02407-7

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