scholarly journals Ovarian Cancer Incidence Trends in Relation to Changing Patterns of Menopausal Hormone Therapy Use in the United States

2013 ◽  
Vol 31 (17) ◽  
pp. 2146-2151 ◽  
Author(s):  
Hannah P. Yang ◽  
William F. Anderson ◽  
Philip S. Rosenberg ◽  
Britton Trabert ◽  
Gretchen L. Gierach ◽  
...  

Purpose After a report from the Women's Health Initiative (WHI) in 2002, a precipitous decline in menopausal hormonal therapy (MHT) use in the United States was linked to a decline in breast cancer incidence rates. Given that MHT use is also associated with increased ovarian cancer risk, we tested whether ovarian cancer incidence rates changed after 2002. Methods Using the North American Association of Central Cancer Registries database (1995 to 2008; N = 171,142 incident ovarian cancers), we applied standard analytic approaches and age-period-cohort (APC) models to estimate ovarian cancer incidence rate changes before (1995 to 2002) and after (2003 to 2008) the WHI report. Results Among women age ≥ 50 years, age-standardized ovarian cancer incidence declined by 0.8% per year (95% CI, −1.8% to −0.5% per year) before the WHI announcement; after the WHI report, the rate declined by 2.4% per year (95% CI, −2.5% to −2.2% per year). APC models confirmed an accelerated decline in ovarian cancer incidence after the WHI report, adjusted for age and birth cohort effects. This sudden change was notable among women most likely to have used MHT (ie, women age 50 to 69 years, white women, and residents of regions with highest MHT prescription frequency). The largest changes were found for the endometrioid histologic subtype. Conclusion After a marked reduction in MHT use around 2002, ovarian cancer incidence rates demonstrated an accelerated decline, with the largest changes for endometrioid carcinomas. This strong temporal association, although not proving a causal role of hormones in ovarian carcinogenesis, suggests that future analytic research supporting cancer control efforts should clarify the role of hormonal exposures on the development and behavior of subtypes of ovarian cancer.

2014 ◽  
Vol 24 (2) ◽  
pp. 247-251 ◽  
Author(s):  
Gary G. Schwartz ◽  
Abe E. Sahmoun

ObjectiveOvarian cancer is primarily a disease of the industrialized world. However, few factors associated with industrialization that contribute to the etiology of ovarian cancer have been identified. We sought to explore factors potentially associated with ovarian cancer by correlating ovarian cancer incidence rates in US states with the distribution of US manufacturing.MethodsData on age-adjusted incidence rates for ovarian cancer per state in the United States and manufacturing rates per state were analyzed using multiple linear regression controlling for access to ovarian cancer care, fertility rate, and other potential confounders.ResultsIn univariate analyses, ovarian cancer incidence rates were positively correlated with the extent of manufacturing, with dairy production, and with the manufacturing of pulp and paper. Using multiple linear regression, only the correlation of ovarian cancer with pulp and paper manufacturing industry was significant. The correlation of ovarian cancer with pulp and paper manufacturing industry remained significant after adjusting for access to ovarian cancer care, fertility rates, and other potential confounders (P< 0.05).ConclusionsPulp and paper mills are associated with exposures to known ovarian carcinogens. Further epidemiological study of exposures involved in the manufacturing of pulp and paper in relation to risk of ovarian cancer is warranted.


2003 ◽  
Vol 21 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Christopher I. Li ◽  
Janet R. Daling ◽  
Kathleen E. Malone

Purpose: Between 1987 and 1998, breast cancer incidence rates rose 0.5%/yr in the United States. A question of potential etiologic and clinical importance is whether the hormone receptor status of breast tumors is also changing over time. This is because hormone receptor status may reflect different etiologic pathways and is useful in predicting response to adjuvant therapy and prognosis. Methods: Age-adjusted, age-specific breast cancer incidence rates by estrogen receptor (ER) and progesterone receptor (PR) status from 1992 to 1998 were obtained and compared from 11 population-based cancer registries in the United States that participate in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. Results: From 1992 to1998, the overall proportion of breast cancers that were ER-positive and PR-positive increased from 75.4% to 77.5% (P = .0002) and from 65.0% to 67.7% (P < .0001), respectively, continuing trends observed before 1992. These increases were limited to women 40 to 69 years of age. The proportions of ER-positive/PR-positive tumors increased from 56.7% to 62.3% (P = .0010) among 40- to 49-year-olds, from 58.0% to 63.2% (P = .0002) among 50- to 59-year-olds, and from 63.2% to 67.9% (P = .0020) among 60- to 69-year-olds. Conclusion: From 1992 to 1998, the proportion of tumors that are hormone receptor–positive rose as the proportion of hormone receptor–negative tumors declined. Because the incidence rates of hormone receptor–negative tumors remained fairly constant over these years, the overall rise in breast cancer incidence rates in the United States seems to be primarily a result of the increase in the incidence of hormone receptor–positive tumors. Hormonal factors may account for this trend.


2012 ◽  
Vol 5 (11 Supplement) ◽  
pp. A113-A113
Author(s):  
Jennifer Drahos ◽  
Manxia Wu ◽  
William F. Anderson ◽  
Katrina F. Trivers ◽  
Jessica King ◽  
...  

Author(s):  
Nicholas Salas

As of 2014, Texas has the 6th highest incidence rate and the 5th highest mortality rate of cervical cancer in the nation. In addition, Texas ranks 3rd to last in the United States in human papilloma (HPV) vaccinations, which helps prevent one of the leading causes of cervical cancer. Cervical cancer incidence rates in Texas remain high, despite it becoming one the most successfully preventable treatable cancers in the United States due to a combination of screenings and HPV vaccinations. Furthermore, spatial distribution of cervical cancer is unknown among Texas counties. This study will follow the political ecology model to elaborate on the political, historical, social, and economic factors that may explain why HPV vaccinations are low and the incidence rate remains high despite the interventions available to people in Texas. This study will examine the geography of cervical cancer in Texas counties from 1995 - 2015 as well as its relationship with religious adherence, socioeconomic status, race/ethnicity, and uninsured rates. I will use a bivariate correlation to relate these factors with cancer incidence rates and ArcMap to create maps to illustrate the spatial distribution of these diseases. The data will be obtained from the Texas Cancer Registry, Texas County Health Rankings 2018, and the Association of Religion Data (CDC) Archives (ARDA). I expect that cervical cancer rates will decline after the introduction of the HPV vaccine in 2007, but areas with higher religious adherence will have higher rates of cervical cancer. In addition, I expect that uninsured rates, race/ethnicity, and socioeconomic factors could possibly impact cervical cancer incidence rates.


2018 ◽  
Vol 168 (12) ◽  
pp. 866 ◽  
Author(s):  
Meredith S. Shiels ◽  
Jessica Y. Islam ◽  
Philip S. Rosenberg ◽  
H. Irene Hall ◽  
Evin Jacobson ◽  
...  

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