Skip to main content
SpringerLink
Log in

Reduced risk of breast and endometrial cancer among women with hip fractures (Sweden)

  • Research Papers
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

To test the hypothesis that osteoporosis, which results partly from long-term estrogen deficiency, is associated with a lowered risk of breast and endometrial cancer, a population-based cohort study was performed in Sweden. Some 18,000 women were followed through record-linkages after a first hip fracture, on average for almost six years, to ascertain the incidence of breast and endometrial cancer. Expected numbers were derived from the general population. Overall, 253 cases of breast cancer were observedcf 300 expected (standardized incidence ratio [SIR]=0.84; 95 percent confidence interval [CI]=0.74–0.95). Forty-eight cases of endometrial cancer were foundcf 55 expected (SIR=0.87, CI=0.54–1.16). There was no clearcut pattern of breast cancer risk by age at diagnosis of hip fracture, follow-up time, or calendar period. Our results are consistent with thea priori hypothesis that long-term estrogen deficiency is associated with a reduced risk of developing breast cancer as well as endometrial cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adami HO, Adams G, Boyle P et al., Breast cancer etiology. Report from a working party for the Nordic Cancer Union Meeting 1989.Int J Cancer 1990; suppl 5:22–39.

    Google Scholar 

  2. Kelsey JL, Gammon MD. Epidemiology of breast cancer.Epidemiol Rev 1990;12:228–40.

    PubMed  Google Scholar 

  3. Boyle P. Epidemiology of breast cancer.Baillière's Clin Oncol 1988;2: 1–59.

    Google Scholar 

  4. Brinton LA, Schairer C, Hoover RN, Fraumeni JF Jr. Menstrual factors and risk of breast cancer.Cancer Invest 1988;6:245–54.

    PubMed  Google Scholar 

  5. MacMahon B, Cole P, Lin TM, et al. Age at first birth and cancer of the breast. A summary of an international study.Bulletin of the WHO 1970;43:209–21.

    Google Scholar 

  6. Henderson BE, Ross RK, Judd HL Krailo MD, Pike MC. Do regular ovulatory cycles increase breast-cancer risk?Cancer 1985;56:1206–8.

    PubMed  Google Scholar 

  7. Rose DP. Dietary factors and breast cancer.Cancer Surv 1986;5:671–82.

    PubMed  Google Scholar 

  8. UK Natinal Case Control Study Group. Oral contraceptive use and breast cancer risk in young women.Lancet 1989;i:973–82.

    Google Scholar 

  9. Steinberg KK, Thacker SB, Smith SJ, et al. A meta-analysis of the effect of estrogen replacement therapy on the risk of breast cancer.JAMA 1991;265:1985–90.

    PubMed  Google Scholar 

  10. De Waard F, Trichopoulos D. A unifying concept of the aetiology of breast cancer.Int J Cancer 1988;41:666–9

    PubMed  Google Scholar 

  11. Key TJA, Pike MC. The role of oestrogens and progestogens in the epidemiology and prevention of breast cancer.Eur J Cancer Clin Oncol 1988;24:29–43.

    PubMed  Google Scholar 

  12. Parazzini F, La Vecchia C, Bocciolone L, Francheschi S. The epidemiology of endometrial cancer.Gynecol Oncol 1991;41:1–16.

    PubMed  Google Scholar 

  13. Herrington LJ, Weiss NS. Postmenopausal unopposed estrogens characteristics of use in relation to the risk of endometrial carcinoma.Ann Epidemiol 1993;3:308–18.

    PubMed  Google Scholar 

  14. Whitehead MI, Townsend PT, Pryse-Davies J, Ryder TA, King RJB. Effects of estrogens and progestins on the biochemistry and morphology of the post-menopausal endometrium.N Engl J Med 1981;301:1599–605.

    Google Scholar 

  15. Cummings SR, Kelsy JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures.Epidemiol Rev 1985;7:178–208.

    PubMed  Google Scholar 

  16. Drinkwater BL, Nilson K, Chesnut CH, et al. Bone mineral content of amenorrheic and eumenorrheic athletes.N Engl J Med 1984;311:277–81.

    PubMed  Google Scholar 

  17. Genant HK, Cann CE, Ettinger B, Gordon GS. Quantitative computed tomography of vertebral spongiosa: A sensitive method for detecting early bone loss after oophorectomy.Ann Intern Med 1982;97:699–705.

    PubMed  Google Scholar 

  18. Adami HO, Zack M, Kressner U, et al. No protection against hip fractures in women with breast cancer. Evidence from a population-based cohort study.Am J Epidemiol 1990;132:877–83.

    PubMed  Google Scholar 

  19. Persson I, Naessén T, Adami HO, et al. Reduced risk of hip fracture in women with endometrial cancer.Int J Epidemiol 1992;21: 638–42.

    Google Scholar 

  20. National Board of Health and Welfare.In-patient Statistics from Hospitals for Physical Diseases in the Uppsala Region. Stockholm, Sweden: National Board of Health and Welfare, 1969;Patient Statistics No. 1.

    Google Scholar 

  21. Naessén T, Parker R, Persson I, et al. Time trends in incidence rates of first hip fracture in the Uppsala Health Care Region, Sweden, 1965–1983.Am J Epidemiol 1989;130:289–99.

    PubMed  Google Scholar 

  22. Population Unit.Total Population Register. Örebro, Sweden: Statistics Sweden, 1993.

    Google Scholar 

  23. The Cancer Registry,Cancer Incidence in Sweden 1987. Stockholm, Sweden.: National Board of Health and Welfare, 1992.

    Google Scholar 

  24. World Health Organization.International Classification of Diseases. Seventh Revision Geneva, Switzerland: WHO, 1957.

    Google Scholar 

  25. World Health Organization.International Classification of Diseases. Eighth Revision. Geneva, Switzerland: WHO, 1967.

    Google Scholar 

  26. Official Statistics of Sweden.Causes of Death 1988. Stockholm, Sweden: National Bureau of Statistics, 1991.

    Google Scholar 

  27. Johnell O, Sernbo I. Health status in patients with hip fractures and controls.Age Ageing 1986;15: 285–91.

    PubMed  Google Scholar 

  28. Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Survival experience of aged hip fracture patients.AJPH 1989;79:274–8.

    Google Scholar 

  29. Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures.Epidemiol Rev 1985;7:178–208.

    PubMed  Google Scholar 

  30. Winner SJ, Morgan CA, Grimley Evans J. Perimenopausal risk of falling and incidence of distal forearm fracture.Br Med J 1989;298:1486–88.

    Google Scholar 

  31. Melton LJ, Kan SH, Frye MA, et al. Epidemiology of vertebral fractures in women.Am J Epidemiol 1989;129 100–11.

    Google Scholar 

  32. Christiansen C, Christiansen MS, McNair P, et al. Prevention of early post-menopausal bone loss: controlled 2-year study in 315 normal females.Eur J Clin Invest 1980;10:273–9.

    PubMed  Google Scholar 

  33. Naessén T, Persson I, Ljunghall S, Bergström R. Women with climacteric symptoms: A target group for prevention of rapid bone loss and osteoporosis.Osteoporosis Int 1992;2:225–31.

    Google Scholar 

  34. Hutchinson TA, Polansky SM, Feinstein AR. Postmenopausal oestrogens protect against fractures of hip and distal radius: a case-control study.Lancet 1979,ii: 705–9.

    Google Scholar 

  35. Kreiger N, Kelsey JL, Holford TR, O'Connor T. Anepidemiologic study of hip fracture in postmenopausal women.Am J Epidemiol 1982;116:141–8.

    PubMed  Google Scholar 

  36. Paganini-Hill A, Ross RK, Gerkins VR, et al. Menopausal estrogen therapy and hip fractures.Ann Intern Med 1981;95:28–31.

    PubMed  Google Scholar 

  37. Weiss NS, Ure CL, Ballard JH, Williams AR, Daling JR. Decreased risk of fractures of the hip and lower forearm with postmenopausal use of estrogen.N Engl J Med 1980;303:1195–8.

    PubMed  Google Scholar 

  38. Kiel DP, Feison DT, Anderson JJ, Wilson PWF, Moskowitz MA. Hip fracture and the use of estrogens in postmenopausal women. The Framingham study.N Engl J Med 1987;317:1169–74.

    PubMed  Google Scholar 

  39. Ettinger B, Genant HK, Cann CE. Long-term estrogen replacement therapy prevents bone loss and fractures.Ann Intern Med 1985;102:319–24.

    PubMed  Google Scholar 

  40. Naessén T, Persson I, Adami HO, Bergström, R, Bergkvist L. Hormonal replacement therapy and the risk for first hip fracture. A prospective, population-based cohort study.Ann Intern Med 1990;113:95–103.

    PubMed  Google Scholar 

  41. Baron JA, La Vecchia C, Levi F. The antiestrogenic effect of cigarette smoking in women.Am J Obstet Gynecol 1990;162:502–14.

    PubMed  Google Scholar 

  42. Pritchard DJ, Burch PA. Orthopedic complications. In: Holland JF, et al., eds.Cancer, Medicine, 3rd edition Philadelphia, PA (US): Lea & Febiger, 1993: 2290–3.

    Google Scholar 

  43. Krane SM, Holich MF. Metabolic bone disease. In: Wilson JD, ed.Harrison's Principles of Internal Medicine, 12th ed. New York, NY (US) McGraw-Hill, Inc, 1991; 1921–32.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University Hospital, Uppsala, Sweden

    Ingemar Persson &  Tord Naessén

  2. Cancer Epidemiology Unit, Uppsala University, University Hospital, S-75185, Uppsala, Sweden

    Hans-Olov Adami

  3. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Hans-Olov Adami

  4. Epidemiology and Biostatistics Program, US National Cancer Institute, Bethesda, MD, USA

    Joseph K. McLaughlin & Joseph F. Fraumeni Jr.

Authors
  1. Ingemar Persson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hans-Olov Adami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joseph K. McLaughlin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tord Naessén
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joseph F. Fraumeni Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Persson, I., Adami, HO., McLaughlin, J.K. et al. Reduced risk of breast and endometrial cancer among women with hip fractures (Sweden). Cancer Causes Control 5, 523–528 (1994). https://doi.org/10.1007/BF01831380

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01831380

Key words

Search

Navigation