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La terapia de reemplazo hormonal en la menopausia y el riesgo de cáncer de ovario
James V Lacey1, Pamela J Mink, Jay H Lubin
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd, MSC 7234, Rockville, MD 20852, USA. jimlacey@nih.gov
JAMA
|July 16, 2002
Resumen
La terapia de reemplazo hormonal de estrógeno solo a largo plazo aumenta significativamente el riesgo de cáncer de ovario. La terapia de estrógeno-progestina no mostró un aumento del riesgo con el uso a corto plazo, pero los efectos a largo plazo requieren más estudios.
Área de la Ciencia:
- Ginecología Ginecología.
- Oncología Oncología.
- Epidemiología La epidemiología.
Sus antecedentes:
- La relación entre la terapia de reemplazo hormonal (TRH) en la menopausia y el riesgo de cáncer de ovario sigue sin estar clara.
- Este estudio investiga la asociación entre los diferentes tipos de TRH y la incidencia de cáncer de ovario.
Objetivo del estudio:
- Para determinar si la TRH solo estrógeno, estrógeno-progestina o combinada aumenta el riesgo de cáncer de ovario.
- Evaluar el impacto de la duración del uso de TRH en el riesgo de cáncer de ovario.
Principales métodos:
- Un estudio de cohorte de 44.241 mujeres posmenopáusicas entre 1979 y 1998.
- Datos recopilados de ex participantes del Proyecto de Demostración de Detección de Cáncer de Mama en 29 centros clínicos estadounidenses.
- La incidencia de cáncer de ovario fue la principal medida de resultado, con análisis dependientes del tiempo ajustados por factores de riesgo relevantes.
Principales resultados:
- El uso de TRH solo con estrógeno se asoció significativamente con un mayor riesgo de cáncer de ovario (RR, 1.6).
- El aumento de la duración del uso solo de estrógenos mostró una relación dosis-respuesta significativa con el riesgo de cáncer de ovario (20+ años: RR, 3.2).
- La TRH de estrógeno-progestina sola no mostró un aumento significativo en el riesgo de cáncer de ovario, incluso con una mayor duración de uso.
Conclusiones:
- El uso a largo plazo de TRH solo con estrógeno (≥10 años) está relacionado con un riesgo significativamente elevado de cáncer de ovario.
- El uso a corto plazo de TRH solo estrógeno-progestina no se asoció con un aumento del riesgo.
- Se necesita más investigación para aclarar los riesgos asociados con la terapia de reemplazo estrógeno-progestina a corto y largo plazo.
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