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Estrógeno de baja potencia y riesgo de cáncer de endometrio: un estudio de caso-control
E Weiderpass1, J A Baron, H O Adami
1Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. Elisabete.Weiderpass@mep.ki.se
Lancet (London, England)
|June 8, 1999
Resumen
Las formulaciones orales de estrógeno de baja potencia, particularmente el estriol, aumentan significativamente el riesgo de cáncer de endometrio en mujeres posmenopáusicas. El uso vaginal mostró una asociación mínima, lo que pone de relieve la necesidad de un monitoreo cuidadoso y la consideración del progestageno.
Área de la Ciencia:
- Oncología Ginecológica Oncología Ginecológica.
- Endocrinología Endocrinología.
- Salud reproductiva y salud reproductiva.
Sus antecedentes:
- Los síntomas urogenitales son frecuentes en las mujeres posmenopáusicas y a menudo se tratan con estrógeno de baja potencia.
- La seguridad endometrial de estas formulaciones, especialmente con respecto al riesgo de neoplasia, sigue siendo incompletamente entendida.
Objetivo del estudio:
- Investigar la asociación entre las formulaciones de estrógeno de baja potencia y el riesgo de neoplasia endometrial en mujeres posmenopáusicas.
Principales métodos:
- Un estudio de caso-control basado en la población a nivel nacional en Suecia.
- Se trataba de 789 casos de cáncer de endometrio y 3368 controles.
- Utilizó regresión logística incondicional para el cálculo de la relación de probabilidades después de la revisión histopatológica y el ajuste multivariado.
Principales resultados:
- El uso oral de estriol (1-2 mg diarios) durante ≥5 años se asoció con un mayor riesgo relativo de cáncer de endometrio (OR 3.0) y hiperplasia atípica (OR 8.3).
- El riesgo fue mayor para los cánceres bien diferenciados y disminuyó rápidamente después de la interrupción del tratamiento.
- Los estrógenos vaginales de baja potencia solo mostraron asociaciones débiles con el riesgo de neoplasia endometrial.
Conclusiones:
- Las formulaciones orales de estrógeno de baja potencia, a diferencia de las vaginales, elevan el riesgo de neoplasia endometrial.
- Se recomienda una estrecha vigilancia del paciente y la consideración de la adición de progestagenos para las mujeres que usan formulaciones orales.
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