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Résumé :
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[BDSP. Notice produite par INIST-CNRS 7ArR0xsC. Diffusion soumise à autorisation]. We assessed whether different oral progestogens in hormone replacement therapy may differentially affect the risk of endometrial cancer, using data from the Etude Epidémiologique aupres de femmes de l'Education Nationale (E3N), a French cohort study (1992-2008). Hazard ratios and their confidence intervals were derived from Cox models. Among 65,630 postmenopausal women (mean follow-up : 10.8 years), 301 endometrial cancers occurred. Compared with never use, ever use of estrogen+micronized progesterone was associated with an increased risk of endometrial cancer (hazard ratio (HR)=1.80,95% confidence interval (CI) : 1.38,2.34) that was significantly more marked with longer duration of use (for5 years, HR=2.66 (95% CI : 1.87,3.77)). Although use of estrogen+dydrogesterone was not associated overall with endometrial cancer risk (HR=1.05,95% CI : 0.76,1.45), there was a significantly increased risk with long-term use compared with never use (for>5 years, HR=1.69,95% CI : 1.06,2.70). Users of preparations containing other progesterone derivatives or a norsteroid derivative were not at significantly increased risk (HR=0.79 (95% CI : 0.60,1.05) and HR=1.30 (95% CI : 0.85,1.99), respectively). In conclusion, micronized progesterone and, to a lesser extent, dydrogesterone at the doses used in France may not be sufficient to prevent estrogen-induced endometrial cancers.
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