Yuk Jin-Sung, Kim Myounghwan
From the Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea.
Menopause. 2023 May 1;30(5):490-496. doi: 10.1097/GME.0000000000002176. Epub 2023 Apr 4.
This study aimed to evaluate the risk of ovarian cancer associated with hormone therapy regimens using a Korean population-based study.
This retrospective cohort study used national health checkup and insurance data from January 1, 2002, to December 31, 2019, provided by Korea's National Health Insurance Service. Women older than 40 years who recorded "menopause" in the questionnaire from 2002 to 2011 were included in this study. Menopausal hormone therapy (MHT) preparations were classified into tibolone, combined estrogen plus progestin by the manufacturer, combined estrogen plus progestin by physician, estrogen, and topical estrogen groups. The number of participants recorded as menopausal during the national health examination between 2002 and 2011 was 2,506,271. The MHT and non-MHT groups consisted of 373,271 and 1,382,653 patients, respectively. The hazard ratios (HR) of ovarian cancer according to MHT type, age at inclusion, body mass index, region, socioeconomic status, Charlson comorbidity index, age at menarche, age at menopause, parity, smoking, alcohol consumption, physical exercise, and period from menopause to inclusion were evaluated.
The risk of ovarian cancer was reduced in the tibolone group (HR, 0.84; 95% confidence interval, 0.75-0.93; P = 0.003) and in patients in rural areas (HR, 0.90; 95% confidence interval, 0.845-0.98; P = 0.013). The risk of ovarian cancer was not related to the other MHT treatments.
Tibolone was associated with a lower risk of ovarian cancer. No other MHT was associated with ovarian cancer.
本研究旨在通过一项基于韩国人群的研究，评估激素治疗方案与卵巢癌风险之间的关联。
这项回顾性队列研究使用了韩国国民健康保险服务提供的2002年1月1日至2019年12月31日的全国健康检查和保险数据。本研究纳入了2002年至2011年在问卷中记录有“绝经”的40岁以上女性。绝经激素治疗（MHT）制剂按制造商分为替勃龙、联合雌激素加孕激素、医生处方的联合雌激素加孕激素、雌激素和局部雌激素组。2002年至2011年全国健康检查期间记录为绝经的参与者有2506271人。MHT组和非MHT组分别有373271例和1382653例患者。评估了根据MHT类型、纳入时年龄、体重指数、地区、社会经济地位、Charlson合并症指数、初潮年龄、绝经年龄、产次、吸烟、饮酒、体育锻炼以及从绝经到纳入的时间等因素导致的卵巢癌风险比（HR）。
替勃龙组（HR，0.84；95%置信区间，0.75 - 0.93；P = 0.003）和农村地区患者（HR，0.90；95%置信区间，0.845 - 0.98；P = 0.013）的卵巢癌风险降低。卵巢癌风险与其他MHT治疗无关。
替勃龙与较低的卵巢癌风险相关。其他MHT均与卵巢癌无关。
