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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Female residents of King County, Washington, in whom endometrial cancer developed between January 1975 and April 1976 were interviewed concerning prior use of menopausal estrogens. Their responses were compared with those of a random sample of women from the same population. Among current estrogen users, endometrial cancer risk was strongly related to duration of use; although only a minimal elevation of risk was present during the first two years, there was a rapid rise to a 20-fold excess after about ten to 15 years. Cessation of estrogen use led to a decline in incidence of endometrial cancer within several years, but the risk remained higher than in nonusers through the first decade after administration of the drug was stopped. Risk was elevated whether or not the regimen was cyclic and whether conjugated or other types of estrogens had been used. Dosages of less than 0.625 mg/day of conjugated estrogens produced a smaller increase in risk than did other dosages.
JAMA 1979 Jul 20
PMID:Endometrial cancer in relation to patterns of menopausal estrogen use. 44 15

There seems little question that the cause of some endometrial cancer is some carcinogenic agent that may reach the endometrial surface initially as a "chance phenomenon." About 10 years needs to elapse before the earliest morphologic change eventuates in cancer. The question is what chance does an endometrium have of developing malignant neoplasms if it is periodically shed, albeit incompletely, as in normal ovulatory cycles. The occurrence of such an event is very rare. The importance of shedding in the prevention of endometrial cancer is not a new concept. Lipsett indicates that there is a consensus that progestational stimulation of the endometrium with subsequent withdrawal bleeding protects against endometrial cancer. If periodic shedding is important in the prevention of cancer, the important question is whether young women on oral contraceptives (OCs) shed their endometrium when they are bleeding. Studies of the effects of OCs on the endometrium in the 1960s showed that the combined pills produced "marked predecidual changes" but the sequential preparations did not. Predecidual changes are required to render the endometrium deciduous. It might be predicted that the sequentials would predispose to cancer after years of use because shedding probably did not occur. The new question is whether the low dosage OCs (with probable absence of shedding) predispose young women to endometrial cancer. The use of estrogens only with postmenopausal women preserves the unshed endometrium for the requisite number of years to allow a carcinogenic agent to exert its effect.
JAMA 1977 Aug 08
PMID:Prevention of endometrial cancer. 57 69

Estrogen treatment of postmenopausal women is effective in relieving the symptoms of vasomotor instability and urogenital atrophy; estrogen treatment is effective in preventing accelerated bone loss and osteoporosis in young women following castration, but in postmenopausal women aging is a more important determinant of accelerated bone loss than is decreased estrogen secretion. Low-dose estrogen treatment of postmenopausal women neither prevents nor increases the risk of arteriosclerotic cardiovascular disease or cerebral vascular disease. It cannot be definitively established that estrogen treatment of postmenopausal women causes an increased incidence of breast tumors, but it is clear that such treatment does not prevent these tumors. It is established that estrogen treatment of postmenopausal women increases the risk ratio of endometrial carcinoma.
JAMA 1977 Oct 03
PMID:Estrogen treatment of postmenopausal women. Benefits and risks. 57 21

In two case-control studies of estrogens and endometrial cancer, women were asked about previous use of intravaginal estrogen creams. In a set of cases and controls chosen by conventional procedures from a tumor registry, the odds ratio was 0.90. In an alternative set of cases and controls who had all received dilatation and curettage or hysterectomy, the odds ratio was 0.82. Despite the reported relationship between oral estrogens and endometrial cancer and although intravaginal estrogen creams are readily absorbed by the vaginal mucosa, we detect no causal association for their use.
JAMA 1979 Mar 23
PMID:Intravaginal estrogen creams and endometrial cancer: no causal association found. 76 93

The Gravlee jet irrigator was used in 556 women with abnormal uterine bleeding. The irrigator failed to demonstrated endometrial adenocarcinoma in 14 of 25 patients. In ten of these 14, the specimens were found to be unsatisfactory. Twenty-six percent (16 of 61) of those patients with unsatisfactory specimens had a proliferative endometrial lesion. The false-negative rate in diagnosing endometrial cancer with an adequate specimen was 27% (4 of 15). Forty-eight of 61 cases of hyperplastic endometrial lesions were not diagnosed by means of jet irrigation. The irrigation failed to detect premalignant endometrial lesions and was not sufficiently reliable to exclude endometrial carcinoma when a satisfactory negative specimen was obtained.
JAMA 1976 Jun 21
PMID:Gravlee jet irrigator. Efficacy in diagnosis of endometrial neoplasia. 94 90

Of eight young women, seven had a diagnosis of well-differentiated endometrial adenocarcinoma and one had atypical endometrial hyperplasia. The average age was 40.1 years, with 6.04 years of dimethisterone-ethinyl estradiol (Oracon) sequential contraceptive use. The patients were not typical of those in whom endometrial carcinoma develops. Although these cases do not prove that long-term administration of dimethisterone-ethinyl estradiol causes endometrial adenocarcinoma or atypia, they indicate that it may do so.
JAMA 1976 Aug 23
PMID:Severe atypical endometrial changes and sequential contraceptive use. 98 89

To examine the relationship between endometrial cancer and use of specific oral contraceptive (OC) formulations, we used data from the Cancer and Steroid Hormone Study, a multicenter, population-based, case-control study. Cases were 433 women aged 20 to 54 years with histologically confirmed epithelial endometrial cancer ascertained through six population-based cancer registries. Controls were 3191 women selected at random from the populations of these areas. Women who had used combination OCs for at least 12 months had an age-adjusted risk of developing endometrial cancer of 0.6 relative to those women who had never used OCs (95% confidence interval, 0.3 to 0.9). This protective effect persisted for at least 15 years after the cessation of OC use. Examination of the eight most frequently used OC formulations revealed little difference in the age-adjusted risks, which ranged from 0.2 to 0.7 for women who had ever used a formulation compared with women who had never used OCs. Use of OCs for 12 months or longer conferred protection against all three major histologic subtypes of endometrial cancer.
JAMA 1987 Feb 13
PMID:Combination oral contraceptive use and the risk of endometrial cancer. The Cancer and Steroid Hormone Study of the Centers for Disease Control and the National Institute of Child Health and Human Development. 302 23

This article reviews scientific evidence of the risks and benefits of depot medroxyprogesterone acetate (DMPA) and argues that it should be approved for contraceptive use in the US provided that studies of its possible side effects are continued and that women use it only after informed choice. DMPA has the highest use effectiveness of any reversible method and is the only available injectable that is effective for 3 months. It has few potentially harmful metabolic side effects and does not appear to suppress lactation. There appear to be few absolute contraindications to its use except pregnancy. Its benefits have made it popular in different settings; its manufacturer, the Upjohn Company, reports that about 1/2 of DMPA use occurs in developed countries. The World Health Organization Toxicology Review Panel, the US Agency for International Development Ad Hoc Consultative Panel, US Food and Drug Administration scientific advisory panels, and other qualified groups have concluded that the ban on contraceptive use of DMPA is unwarranted. Studies finding an increased incidence of mammary tumors in beagle dogs are of questionable applicability to women because of the different reaction of beagles to progestogens. Other studies have not shown increased incidence of breast disease in DMPA users. Available data do not show that DMPA poses more of a threat of fetal malformation than do other hormonal contraceptives if taken during pregnancy. The use of exogenous estrogens to control heavy bleeding in users is rarely needed; there is no evidence of a permanent impairment of fertility after DMPA use and any association between DMPA use and endometrial cancer remains questionable.
JAMA 1983 Jun 03
PMID:The Food and Drug Administration and medroxyprogesterone acetate. What are the issues? 622 Nov 25

Use of combination oral contraceptives (OCs) has been reported to decrease a woman's risk of endometrial cancer developing. To investigate this issue further, we analyzed data from a multicenter, population-based, case-control study--the Cancer and Steroid Hormone Study conducted by the Centers for Disease Control, Atlanta. Cases are all women 20 to 54 years old with a first diagnosis of endometrial cancer ascertained through eight population-based cancer registries; controls are women selected at random from the population of these eight areas. Analysis of the first 187 cases and 1,320 controls showed that women who had used combination OCs at some time in their lives had a relative risk of endometrial cancer developing of 0.5 (95% confidence interval, 0.4 to 0.8) compared with never-users. The protective effect occurred in women who had used combination OCs for at least 12 months, and it persisted for at least ten years after the cessation of OC use. The protective effect was most notable for nulliparous women. Nulliparous combination OC users had a risk 0.4 times (95% confidence interval, 0.2 to 0.9) that of nulliparous never-users. These results were not accounted for by differences between cases and controls in health status, parity, infertility, or other potentially confounding variables. We estimate that approximately 2,000 cases of endometrial cancer are averted each year by past and current OC use among women in the United States.
JAMA 1983 Mar 25
PMID:Oral contraceptive use and the risk of endometrial cancer. The Centers for Disease Control Cancer and Steroid Hormone Study. 633 65

79 patients with endometrial carcinoma were compared with 203 control subjects regarding their use of combined oral contraceptives (OCs). The patients comprised all North Carolina residents with histologically confirmed endometrial carcinoma initially treated at North Carolina Memorial Hospital between 1970-76. Overall, 6.3% of patients and 15.3% of control subjects had used these products. The risk of endometrail cancer for users of OCs was less than half the risk for nonusers. 5 years or more of use reduced the risk to a third. Recent users were strongly protected, whereas discontinuation resulted in risks returning to those of nonusers. Furthermore, OCs with predominantly progestational effects or intermediate formulations produced greater protection than those predominantly estrogenic. This pattern is biologically consistent with a protective effect of combined OCs against endometrial carcinoma.
JAMA
PMID:Protection against endometrial carcinoma by combination-product oral contraceptives. 703 75


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