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

21 women (mean age 60 years, range 48-72) were given depot medroxyprogesterone acetate (DMPA), 1,000 mg/week parenterally for 6 months, as part of the treatment for endometrial carcinoma in either clinical stage I or II. Before treatment and after 1, 3 and 6 months of treatment serum apolipoprotein AI was analyzed by electroimmunoassay. There was a significant decrease in apolipoprotein AI after the administration of DMPA, compared to the value before treatment. A low level of apolipoprotein AI is considered a risk factor for the development of atherosclerosis and cardiovascular disease. Such a risk might therefore be anticipated if the period of treatment was extended to several years.
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PMID:Changes in apolipoprotein AI after treatment with high-dose medroxyprogesterone acetate. 623 58

The epidemiological evidence suggesting an association between the administration of exogenous oestrogens and an increased risk of developing endometrial adenocarcinoma is critically reviewed and it is concluded that the case for oestrogens being a cause of endometrial cancer is proven. The benefits flowing from preventing postmenopausal osteoporosis by oestrogen replacement therapy are assessed and contrasted with the danger to life posed by endometrial adenocarcinoma: it is pointed out that the type of neoplasm developing in patients taking oestrogens is well differentiated, nonaggressive and easily cured, the survival rate being very high. The addition of progestational agents to the therapeutic regime may prevent the development of endometrial carcinoma but could introduce a risk of cardiovascular disease.
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PMID:Endometrial carcinogenesis and its relation to oestrogens. 639 Mar 90

According to animal, human, and laboratory data, the major, life-threatening risks to the woman from exogenous estrogens are neoplastic and cardiovascular. These risks are, to some extent, related to dose, duration of therapy, and certain predisposing individual factors. Except for endometrial carcinoma, the risks have not been adequately studied and are therefore not defined. Because of their potential magnitude collectively, no intelligent assessment of the risk-benefit ratios can be can be carried out until the effect, if any, on the susceptibility for breast carcinoma, ovarian carcinoma, and cardiovascular disease is determined.
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PMID:The benefits of estrogen to the menopausal woman outweigh the risks of developing endometrial cancer. 643 Apr 82

The usefulness of oral contraceptives (OCs) has been fully reappraised in recent years, and numerous beneficial effects on general health have been demonstrated over and above contraceptive action. Examination of several prospective and retrospective epidemiological studies has pointed to a reduced incidence of ovarian functional cysts and ovarian carcinoma in women taking OCs. Dysmenorrhea and premenstrual tension are also diminished while the risk of iron-deficiency anemia is decreased by 50% owing to a reduction in menstrual flow. There is approximately a 50% reduction in endometrial carcinoma risk, coupled with a significant reduction in the incidence of benign breast diseases. OCs also offer protection against rheumatoid arthritis and pelvic inflammation. Lastly, it is pointed that fears concerning augmented risk for cardiovascular disease while on OCs have proven to be false alarms. (author's modified)
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PMID:[Positive effects of oral contraceptives]. 668 43

This National Institutes of Health consensus report of a panel of experts summarizes the currently available information on postmenopausal estrogen use, as presented by the invited speakers, panelists, and members of the audience, and each section published here represents an excerpt of the consensus statement followed by commentary. Reference to 3 background papers, which are published and available, is made for presentation of more detailed discussion. The following consensus was reached concerning estrogen use and postmenopausal women: 1) the use of estrogens alleviates vasomotor symptoms and atrophy of vaginal epithelium and may aid in preventing osteoporosis. The possibility of increased incidence of endometrial cancer with estrogen use is also acknowledged. Combinations of progestin and estrogen may alleviate this increased risk, but potential risks of progestin have not been studied adequately in postmenopausal women with no ovarian function. 2) there is no convincing evidence that postmenopausal estrogen use influences occurrence of cardiovascular disease and breast cancer. Also agreed upon is the patient management of a potential estrogen replacement therapy candidate: she should be given as much information as possible about both benefits and risks and with her physician's help, she should reach an individualized decision about estrogen use.
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PMID:Estrogen use and postmenopausal women: a basis for informed decisions. NIH Consensus Development. 700 87

The use of estrogen replacement therapy in postmenopausal women is under close scrutiny. The indications and side effects of replacement therapy are reviewed, and recommendations regarding its use are made. Hot flashes, atrophy of the vaginal epithelium, and prevention of osteoporosis have been established as indications for estrogen replacement therapy. Prevention of cardiovascular disease, aging changes of skin, and the occurrence of mental illness have also been suggested as indications, but beneficial effects of estrogen replacement therapy for these problems have not been clearly established. Studies have shown that side effects of estrogen replacement therapy include endometrial cancer, hypertension, gallbladder disease, and angina pectoris. Breast cancer may also be a risk factor, but a consensus of opinion has not been established. Pulmonary embolism, cerebral vascular accident, or myocardial infarction has not been associated with estrogen replacement therapy. The use of progesterone with estrogen replacement therapy has been shown to reduce the occurrence rate of endometrial carcinoma, but it does not prevent all the actions of estrogen. Oral administration of estrogen is the preferred route despite misgivings about portal absorption and liver metabolism. Further studies must examine this question. Various agents have been shown to be effective in treating some climacteric symptoms. These include progesterone for hot flashes and calcium for the prevention of osteoporosis. Other agents may also be effective but have not been tested critically.
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PMID:Estrogen replacement therapy. 702 79

After reviewing the pathophysiology of the menopause, attention is directed to a review of the benefits of estrogen progestogen replacement therapy (vasomotor symptoms, urogenital atrophy, psychosomatic complaints, osteoporosis, cardiovascular disease, lipid metabolism); the risks of estrogen progestogen replacement therapy (endometrial cancer, endometrial hyperlasia, breast cancer, coagulation factors, gallbladder disease); and evaluation for estrogen therapy (nonoral estrogen administration). This author regards the menopause to be a hormonal deficiency state, and, like all endocrinopathies, should be managed as vigorously as need be, and without a necessary limitation of time. A wide variety of physical changes and symptoms have been associated with the climacteric. Some patients may only experience cessation of menses; others experience severe reactions that are occasionally disabling. Several factors may influence development of symptoms during the postmenopausal years, and the most important factor is probably the degree of estrogen depletion and the rate at which estrogen levels decrease. Additional factors may be an inherited or acquired propensity to withstand or succumb to the aging process and the psychologic impact of aging and the woman's ability to accept or deny the emotional changes of the menopause. The proven and almost universally accepted benefits of estrogen replacement therapy include relief of vasomotor symptoms, prevention of atrophic vaginitis, and prevention of osteoporosis. Estrogens may also help alleviate some of the psychogenic manifestations that menopause aggravates. Decreasing the risk of cardiovascular disease, particularly in oophorectomized young women may be another benefit by estrogen increased HDL cholesterol. 10 days of cyclic progestogen reduces the risk of endometrial cancer by preventing or treating estrogen induced endometrial hyperplasia. The risk of breast cancer has not been shown to be increased with estrogen therapy, and progestogens may provide additional protection for this tumor. The prognosis for breast carcinoma developing in hormone users is improved, most likely because of an earlier detection. Estrogens prevent demineralization of bone, and the addition of progestogen apparently promotes new bone formation. An increased risk of gallbladder disease may be associated with estrogen therapy, but this risk is minimal and has not been observed in all studies. There is no evidence that either estrogens or progestogens, in the small doses needed for menopause, increase the risk of thromboembolic disease. Newer routes of estrogen administration may further reduce the risks and increase the benefits.
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PMID:The menopause: benefits and risks of estrogen-progestogen replacement therapy. 704 Jan 16

The present level of understanding of the known risks of oral contraceptive (OC) use are summarized. The findings of many investigations in the late 1960s and early 1970s may no longer be totally appropriate because OCs available then had higher dosages than today. Also, early studies enrolled predominantly women in their 20s, who are now almost all more than 35 years old. Thus, the risks observed in these studies may not be applicable to younger women using OCs today. Another consideration has been underscored by the results of the Walnut Creek Study. Behavioral characteristics such as smoking, drinking, and sexual activity are factors which can strongly confound risks of OC use and must be considered when assessing current and future investigations. Many studies have clearly shown that the most serious life threatening danger associated with OC use is that of cardiovascular complications arising from the interaction of OC use and smoking. The increased risks attributable to smoking while using OCs account for a substantial number of the deaths recorded. The Walnut Creek Study showed a somewhat different outcome. Its data suggest no significant risk of myocardial infarction (MI), ischemic heart disease, cerebral thrombosis, or ischemic cerebrovascular disease associated with OC use, but there were nonsignificant increases noted in some cardiovascular diseases which appeared to be explained by a synergism between current use and heavy smoking. Age also has a strong influence on risk for cardiovascular disease. The results of earlier studies seem to indicate that OC use is associated with a risk of subarachnoid hemorrhage. The Walnut Creek Study also noted an increased risk of subarachnoid hemorrhage associated with OC use and found that risk increased with use. Several studies have shown that the incidence of venous thrombosis seems dependent on the dosage of the OC used. An overwhelming majority of studies on the carcinogenicity of OCs have found no increased incidence of cancer of the ovaries, uterus, or breast among users. In regard to both ovaries and endometrium, there is some evidence that OCs may be protective. Several studies have concluded that OC users have a slightly increased risk of developing malignant melanoma. The results of the Oxford/Family Planning Study show that although previous use of OC by nulliparous women may delay future childbearing by several months, it does not impair longterm potential for pregnancy. No increase in risk of clinically apparent diabetes mellitus has been reported in users. In addition to their possible protection against ovarian and endometrial cancer, OCs may reduce the risk of at least 5 other diseases: benign breast disease; deficiency anemia; arthritis, pelvic inflammatory disease; and ovarian cysts.
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PMID:The pill: an evaluation of recent studies. 704 36

Estrogen replacement therapy (ERT) has been shown to reduce the risk of cardiovascular disease (CVD) and osteoporosis in postmenopausal women. Studies also indicate a reduced risk of stroke and its consequent mortality among estrogen users, and ERT may also have a role in reducing the risk of Alzheimer's disease and increasing a woman's overall quality of life. On the negative side, some studies show a small duration-related risk of breast cancer with estrogen use and a significant increase in endometrial cancer; the latter is virtually eliminated with the addition of a progestin to the regimen. Although the definitive answer is not yet available, recent epidemiologic data suggest no reduction in protection against CVD and bone fracture with the addition of progestin, which is referred to as hormone replacement therapy, as opposed to using estrogen alone. A woman's potential risks associated with ERT or hormone replacement therapy must be weighed against her lifetime risks of developing CVD, stroke, and bone fracture. The reduction in mortality and morbidity rates with hormone use is generally viewed to be substantial and cost-effective. Health care professionals have an important role in shaping their patients' attitudes. Patients need more information from their physicians about the risks and benefits of estrogen therapy.
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PMID:Benefits and risks of estrogen replacement therapy. 757 95

A substantial body of recent experimental, clinical and epidemiological evidence indicates that hormones play a major role in the etiology of several human cancers. The ability of hormones to stimulate cell division in certain target organs such as the breast, endometrium, prostate and the ovary, may lead following repeated cell divisions to accumulation of random genetic errors that ultimately produce the neoplastic phenotype. Hormone-related cancers account for more than 30% of all newly diagnosed female cancers in the United States. While most non-hormone-dependent adult cancers rise continuously with age, hormone-responsive cancers of the breast, the ovary and the endometrium rise with age until menopause, and then distinctly level off to a plateau. These epidemiologic characteristics may indicate that the key etiologic events for these cancers occur in the premenopausal period. Prevention strategies that intervene during the premenopausal period can be expected to have a greater long-term impact in reducing risk than those implemented for an equivalent length of time in the postmenopausal years. Epidemiological studies demonstrate a reduction in endometrial cancer risk of about 11.7% per year of combination oral contraceptive (COC) use; ovarian cancer risk may be reduced by 7.5% per year of COC use, while breast cancer studies have produced mixed results. A comparison of age-adjusted incidence and mortality rates for women less than 50 years of age between the years 1973-1974 and 1986-1987 demonstrate a change in the average rate of breast cancer of plus 9.6% incidence and minus 8.2% mortality; the rates reflect the cancer burden of women who would and would not have had access to COCs during the majority of their child-bearing years. The use of hormone replacement therapy (HRT) is well established to provide short-term relief of symptoms related to menopause and long-term protection from the consequences of estrogen deficiency, such as postmenopausal osteoporosis and cardiovascular disease. Besides COCs, use of HRT constitutes the other major setting in which exogenous steroid hormones are widely used in essentially healthy women and has had a remarkable impact on cancer incidence and mortality. Estrogen replacement therapy (ERT) and endometrial cancer risk are strongly associated with respect to both dose and duration. Endometrial cell mitotic activity during continuous high-dose estrogen monotherapy equals that observed during the follicular phase of the menstrual cycle, and the total mitotic activity over a 28-day period amounts to roughly double that of a premenopausal woman as long as there is no opposition by a progestogen.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Does HRT modify risk of gynecological cancers? 758 88


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