Estrogen—a cause of gynecologic cancer?

Autor: William E. Lucas
Rok vydání: 1981
Předmět:
Zdroj: Cancer. 48:451-454
ISSN: 1097-0142
0008-543X
DOI: 10.1002/1097-0142(19810715)48:1+<451::aid-cncr2820481305>3.0.co;2-h
Popis: The "estrogen hypothesis" relating estrogen stimulation of the endometrium to the eventual production of endometrial neoplasia arose from observations regarding: 1) increased incidence of endometrial hyperplasia and adenocarcinoma in patients with chronic anovulation estrogen-secreting tumors and adenomatous endometrial hyperplasia; 2) development of endometrial cancer in estrogen-treated animals and in patients with dysgenetic gonads after long-term estrogen therapy; 3) successful treatment of endometrial hyperplasia and well-differentiated carcinoma with anti-estrogens. Case control studies carried out since 1975 positively correlated the increased risk of endometrial cancer among estrogen users with duration of use and dose. Risk ratio among estrogen users varies from 2 to 14 with the most common estimate being between 3 and 8. The cumulative risk starting at age 50 of developing endometrial cancer has been calculated to be 1% after 5 years and 3.6% after 10 years for estrogen users and 0.3% at 5 years and 0.8% at 10 years for nonestrogen users. The effect of exogenous estrogen therapy with the exception of long-term high dose estrogen therapy on breast cancer is not well established. The incidence of breast cancer has not changed significantly in the last 2 decades unlike that of endometrial cancer. Many established breast cancers contain estrogen receptors and are sensitive to changes in serum estrogen levels. It is not known whether estrogens per se cause any cancer in humans although long-term estrogen use is known to promote the development of a subgroup of endometrial cancers that are usually well differentiated and associated with low mortality. Many cancers are known to occur in estrogen-sensitive tissues in women who have never been estrogen users are not obese have normal reproductive histories and are otherwise healthy. It is also suggested that low dose estrogen replacement therapy provides benefits which often outweigh the risks of developing cancer.
Databáze: OpenAIRE
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