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Estrogen Therapy and Endometrial Carcinoma

Martin H. Cohen, MD
Arch Intern Med. 1978;138(4):526-527. doi:10.1001/archinte.1978.03630280008004.
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Kandekar et al, in this issue (p 539), suggest that endometrial cancer may result from estrogen therapy of breast cancer. A similar association has been reported by Hoover and associates.1

These reports reflect one aspect of a more general problem that concerns the association of postmenopausal estrogen replacement therapy with the development of endometrial carcinoma. The results of four retrospective epidemiologic studies disclose that estrogen-treated patients had a 4% to 14% greater likelihood of developing endometrial cancer than did a control population of women matched for such risk factors as age, obesity, nulliparity, hypertension, diabetes mellitus, menopause at later than 50 years, menarche before age 13 years, and family history of gynecologic malignancy.2-5 While methodologic aspects of these studies have been criticized,6,7 the magnitude of the increased risk suggests that the association of estrogen administration and endometrial cancer is real.8 For comparison, cigarette smokers have a


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