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December 4, 1975New England Journal of Medicine1,014 citations

Increased Risk of Endometrial Carcinoma among Users of Conjugated Estrogens

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HZHarry K. ZielKaiser Permanente West Los Angeles Medical CenterWFWilliam D. FinkleNational Academy of Sciences

Key Points

  • This research aims to determine whether conjugated estrogens increase the risk of endometrial carcinoma.
  • Compared 94 patients with endometrial carcinoma to a twofold age-matched control group.
  • Recorded use of conjugated estrogens, primarily sodium estrone sulfate.
  • Calculated risk ratios and etiologic fractions based on exposure duration.
  • Conjugated estrogens were used by 57% of patients with endometrial carcinoma compared to 15% of controls.
  • The risk ratio for developing endometrial carcinoma with conjugated estrogens was 7.6 (95% CI lower limit 4.7).
  • The estimated proportion of cases related to conjugated estrogens was 50% (95% CI lower limit 41%).

Abstract

The possibility that the use of conjugated estrogens increases the risk of endometrial carcinoma was investigated in patients and a twofold age-matched control series from the same population. Conjugated estrogens (principally sodium estrone sulfate) use was recorded for 57 per cent of 94 patients with endometrial carcinoma, and for 15 per cent of controls. The corresponding point estimate of the (instantaneous) risk ratio was 7.6 with a one-sided 95 per cent lower confidence limit of 4.7. The risk-ratio estimate increased with duration of exposure: from 5.6 for 1 to 4.9 years exposure to 13.9 for seven or more years. The estimated proportion of cases related to conjugated estrogens, the etiologic fraction, was 50 per cent with a one-sided 95 per cent lower confidence limit of 41 per cent. These data suggest that conjugated estrogens have an etiologic role in endometrial carcinoma.

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Cite This Study

Ziel et al. (1975) studied this question.

synapsesocial.com/papers/6a126dfea2d24b27c1674d35https://doi.org/10.1056/nejm197512042932303
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