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Hormone therapy after uterine cervical cancer treatment

a Swedish population–based study

Everhov, Åsa Hallqvist MD1; Nyberg, Tommy MSc1; Bergmark, Karin MD, PhD2; Citarella, Anna PhD3; Rådestad, Angelique Flöter MD, PhD4; Hirschberg, Angelica Lindén MD, PhD4; Smedby, Karin E. MD, PhD5

doi: 10.1097/GME.0000000000000357
Original Articles
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Objective This study aims to assess use of hormone therapy (HT) after cervical cancer treatment in women of premenopause age.

Methods We identified 837 women aged 45 years or younger at diagnosis of cervical cancer in the Swedish Cancer Register from January 1, 2005 to September 30, 2009 with a minimal follow-up of 1.5 years. Information on cancer treatment (surgical operation, radiotherapy, and/or chemotherapy) was obtained through the National Patient Register. Use of HT was estimated through HT dispensing during follow-up as recorded in the Prescribed Drug Register. Percentage of recommended dose was assessed by frequency of HT dispensing at half-year intervals up to April 1, 2011 or a maximal age of 50 years.

Results A total of 257 women (31%) received acute estrogen deprivation due to bilateral salpingo-oophorectomy and/or radiotherapy. Among these women, 171 (67%) of 257 had at least one dispensing of HT during the period 0.5 to 1 year after diagnosis, and 118 (46%) of 257 were dispensed 75% or more of the recommended dose. Proportion users decreased to 39% at 4.5 to 5 years after diagnosis (21% with ≥75% of the recommended dose). Women younger than 40 years had a higher prevalence of HT use at 0.5 to 1 year (79%), decreasing to 45% after 4.5 to 5 years. The results did not vary by cancer histology.

Conclusions Fewer than half of cervical cancer survivors with therapy-induced early menopause used HT at or close to the recommended dose, and the use decreased during follow-up. Increased awareness of the health benefits of HT for this patient group is needed among professionals and women.

From the 1Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; 2Department of Oncology, Sahlgrenska Academy, Gothenburg, Germany; 3Center for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; 4Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; and 5Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

Received July 8, 2014; revised and accepted August 28, 2014.

Funding/support: This work was supported by the Strategic Research Program in Epidemiology at Karolinska Institutet, the Swedish Research Council (grant 20324 to A.L.H.), Karolinska Institutet, and the Stockholm County Council (A.L.H.).

Financial disclosure/conflicts of interest: None reported.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Website (www.menopause.org).

Address correspondence to: Åsa Hallqvist Everhov, MD, Department of Surgery, South Hospital, Stockholm SE 118 61, Sweden. E-mail: asa.hallqvist-everhov@ki.se

© 2015 by The North American Menopause Society.