HORMONE REPLACEMENT THERAPY AND THE RISK OF EPITHELIAL OVARIAN-CARCINOMA - A METAANALYSIS

Objective: To determine if use of postmenopausal hormone replacement t herapy (HRT) increases the risk of invasive epithelial ovarian carcino ma. Data Sources: English-language articles published from January 196 6 to June 1997 examining HRT and ovarian cancer were found by using ME DLINE, searching the bibliographies of relevant articles and by consul ting experts. Study Selection: Of 327 articles identified, nine provid ed data on the risk of invasive cancer among ever-users of HRT and wer e selected for inclusion by consensus of two independent reviewers. St udies were included if cases were age-matched to controls or results w ere age-adjusted and if women with bilateral salpingo-oophorectomy wer e excluded. Tabulation, Integration, and Results: Two independent unbl inded reviewers abstracted data regarding risk of developing epithelia l ovarian carcinoma and use of HRT. A general variance-based, fixed-ef fects model was used to calculate summary relative risks. Ever-use of HRT was associated with an increased risk of developing invasive epith elial ovarian carcinoma (odds ratio [OR] 1.15; 95% confidence interval [CI] 1.05, 1.27). Use of HRT for more than 10 years was associated wi th the greatest risk of ovarian cancer (OR 1.27; 95% CI 1.00, 1.61).Co nclusion: Prolonged use of hormone therapy by postmenopausal women may be associated with an increased risk of developing epithelial carcino ma of the ovary. (Obstet Gynecol 1998;92:472-9. (C) 1998 by The Americ an College of Obstetricians and Gynecologists.)