{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:27:05Z","timestamp":1792160825596,"version":"4.4.0"},"reference-count":48,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"30","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2024,10,20]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>Menopausal hormone therapy's influence on ovarian and endometrial cancers remains unsettled. Therefore, we assessed the long-term influence of conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA) and CEE-alone on ovarian and endometrial cancer incidence and mortality in the Women's Health Initiative randomized, placebo-controlled clinical trials.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>MATERIALS AND METHODS<\/jats:title>\n            <jats:p>Postmenopausal women, age 50-79 years, were entered on two randomized clinical trials evaluating different menopausal hormone therapy regimens. In 16,608 women with a uterus, 8,506 were randomly assigned to once daily 0.625 mg of CEE plus 2.5 mg once daily of MPA and 8,102 placebo. In 10,739 women with previous hysterectomy, 5,310 were randomly assigned to once daily 0.625 mg of CEE-alone and 5,429 placebo. Intervention was stopped for cause before planned 8.5-year intervention after 5.6 years (CEE plus MPA) and after 7.2 years (CEE-alone). Outcomes include incidence and mortality from ovarian and endometrial cancers and deaths after these cancers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>\n              After 20-year follow-up, CEE-alone, versus placebo, significantly increased ovarian cancer incidence (35 cases [0.041%]\n              <jats:italic>v<\/jats:italic>\n              17 [0.020%]; hazard ratio [HR], 2.04 [95% CI, 1.14 to 3.65];\n              <jats:italic>P<\/jats:italic>\n              = .014) and ovarian cancer mortality (\n              <jats:italic>P<\/jats:italic>\n              = .006). By contrast, CEE plus MPA, versus placebo, did not increase ovarian cancer incidence (75 cases [0.051%]\n              <jats:italic>v<\/jats:italic>\n              63 [0.045%]; HR, 1.14 [95% CI, 0.82 to 1.59];\n              <jats:italic>P<\/jats:italic>\n              = .44) or ovarian cancer mortality but did significantly lower endometrial cancer incidence (106 cases [0.073%]\n              <jats:italic>v<\/jats:italic>\n              140 [0.10%]; HR, 0.72 [95% CI, 0.56 to 0.92];\n              <jats:italic>P<\/jats:italic>\n              = .01).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>In randomized clinical trials, CEE-alone increased ovarian cancer incidence and ovarian cancer mortality, while CEE plus MPA did not. By contrast, CEE plus MPA significantly reduced endometrial cancer incidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/jco.23.01918","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T20:02:01Z","timestamp":1724356921000},"page":"3537-3549","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":26,"title":["Menopausal Hormone Therapy and Ovarian and Endometrial Cancers: Long-Term Follow-Up of the Women's Health Initiative Randomized Trials"],"prefix":"10.1200","volume":"42","clinical-trial-number":[{"clinical-trial-number":"nct00000611","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4212-6184","authenticated-orcid":false,"given":"Rowan T.","family":"Chlebowski","sequence":"first","affiliation":[{"name":"The Lundquist Institute, Torrance, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron K.","family":"Aragaki","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3546-2566","authenticated-orcid":false,"given":"Kathy","family":"Pan","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Southern California, Downey, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8563-3330","authenticated-orcid":false,"given":"Reina","family":"Haque","sequence":"additional","affiliation":[{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Rohan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6457-6023","authenticated-orcid":false,"given":"Mihae","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3096-9595","authenticated-orcid":false,"given":"Jean","family":"Wactawski-Wende","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy S.","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY"},{"name":"Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2572-6727","authenticated-orcid":false,"given":"Holly R.","family":"Harris","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Strickler","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Kauntiz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6246-3743","authenticated-orcid":false,"given":"Carolyn D.","family":"Runowicz","sequence":"additional","affiliation":[{"name":"Florida International University Herbert Wertheim College of Medicine, Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_10_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21708"},{"key":"e_1_3_10_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197512042932302"},{"key":"e_1_3_10_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197512042932303"},{"key":"e_1_3_10_5_2","first-page":"95","article-title":"Noncontraceptive estrogen use and the occurrence of ovarian cancer","volume":"68","author":"Weiss NS","year":"1982","unstructured":"Weiss NS, Lyon JL, Krishnamurthy S, et al: Noncontraceptive estrogen use and the occurrence of ovarian cancer. 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