PURPOSE: Raloxifene reduces breast cancer risk in women with osteoporosis, and both tamoxifen and raloxifene prevent breast cancer in high-risk women. However, in vitro, raloxifene does not share the pro-estrogenic effects of tamoxifen on the endometrium. Randomized trials of these agents have provided limited information about endometrial cancer risk in the general population. We sought to compare endometrial cancer risks associated with raloxifene, tamoxifen, and nonusers of a selective estrogen receptor modulator (SERM) in the general population and characterize the endometrial tumors occurring in these groups. METHODS: We performed a case-control study of white and African American women age 50 to 79 years in the Philadelphia area. Patients were diagnosed with endometrial cancer between July 1999 and June 2002. Controls were identified through random-digit dialing. RESULTS: We analyzed 547 cases and 1,410 controls. Among cases, 3.3% had taken raloxifene; 6.2% had taken tamoxifen. Among controls, 6.6% had taken raloxifene; 2.4% had taken tamoxifen. After adjustment for other risk factors, the odds of endometrial cancer among raloxifene users was 50% that of nonusers (odds ratio [OR] = 0.50; 95% CI, 0.29 to 0.85), whereas tamoxifen users had three times the odds of developing endometrial cancer compared with raloxifene users (OR = 3.0; 95% CI, 1.3 to 6.9). Endometrial tumors in raloxifene users had a more favorable histologic profile and were predominantly International Federation of Gynecology and Obstetrics stage I and low grade. CONCLUSION: Raloxifene users had significantly lower odds of endometrial cancer compared with both tamoxifen users and SERM nonusers, suggesting a role for raloxifene in endometrial cancer prevention and individualization of SERM therapy.
PURPOSE:Raloxifene reduces breast cancer risk in women with osteoporosis, and both tamoxifen and raloxifene prevent breast cancer in high-risk women. However, in vitro, raloxifene does not share the pro-estrogenic effects of tamoxifen on the endometrium. Randomized trials of these agents have provided limited information about endometrial cancer risk in the general population. We sought to compare endometrial cancer risks associated with raloxifene, tamoxifen, and nonusers of a selective estrogen receptor modulator (SERM) in the general population and characterize the endometrial tumors occurring in these groups. METHODS: We performed a case-control study of white and African American women age 50 to 79 years in the Philadelphia area. Patients were diagnosed with endometrial cancer between July 1999 and June 2002. Controls were identified through random-digit dialing. RESULTS: We analyzed 547 cases and 1,410 controls. Among cases, 3.3% had taken raloxifene; 6.2% had taken tamoxifen. Among controls, 6.6% had taken raloxifene; 2.4% had taken tamoxifen. After adjustment for other risk factors, the odds of endometrial cancer among raloxifene users was 50% that of nonusers (odds ratio [OR] = 0.50; 95% CI, 0.29 to 0.85), whereas tamoxifen users had three times the odds of developing endometrial cancer compared with raloxifene users (OR = 3.0; 95% CI, 1.3 to 6.9). Endometrial tumors in raloxifene users had a more favorable histologic profile and were predominantly International Federation of Gynecology and Obstetrics stage I and low grade. CONCLUSION:Raloxifene users had significantly lower odds of endometrial cancer compared with both tamoxifen users and SERM nonusers, suggesting a role for raloxifene in endometrial cancer prevention and individualization of SERM therapy.
Authors: T Fornander; L E Rutqvist; B Cedermark; U Glas; A Mattsson; C Silfverswärd; L Skoog; A Somell; T Theve; N Wilking Journal: Lancet Date: 1989-01-21 Impact factor: 79.321
Authors: D Kleinman; M Karas; M Danilenko; A Arbell; C T Roberts; D LeRoith; J Levy; Y Sharoni Journal: Endocrinology Date: 1996-03 Impact factor: 4.736
Authors: B Fisher; J P Costantino; C K Redmond; E R Fisher; D L Wickerham; W M Cronin Journal: J Natl Cancer Inst Date: 1994-04-06 Impact factor: 13.506
Authors: F E van Leeuwen; J Benraadt; J W Coebergh; L A Kiemeney; C H Gimbrère; R Otter; L J Schouten; R A Damhuis; M Bontenbal; F W Diepenhorst Journal: Lancet Date: 1994-02-19 Impact factor: 79.321
Authors: Marian Y Williams-Brown; Sana M Salih; Xia Xu; Timothy D Veenstra; Muhammad Saeed; Shaleen K Theiler; Concepcion R Diaz-Arrastia; Salama A Salama Journal: J Steroid Biochem Mol Biol Date: 2011-05-10 Impact factor: 4.292
Authors: Sang Jun Han; Khurshida Begum; Charles E Foulds; Ross A Hamilton; Suzanna Bailey; Anna Malovannaya; Doug Chan; Jun Qin; Bert W O'Malley Journal: Mol Pharmacol Date: 2015-10-20 Impact factor: 4.436
Authors: Richard J Santen; D Craig Allred; Stacy P Ardoin; David F Archer; Norman Boyd; Glenn D Braunstein; Henry G Burger; Graham A Colditz; Susan R Davis; Marco Gambacciani; Barbara A Gower; Victor W Henderson; Wael N Jarjour; Richard H Karas; Michael Kleerekoper; Roger A Lobo; JoAnn E Manson; Jo Marsden; Kathryn A Martin; Lisa Martin; JoAnn V Pinkerton; David R Rubinow; Helena Teede; Diane M Thiboutot; Wulf H Utian Journal: J Clin Endocrinol Metab Date: 2010-06-21 Impact factor: 5.958
Authors: Stephen D Hursting; John Digiovanni; Andrew J Dannenberg; Maria Azrad; Derek Leroith; Wendy Demark-Wahnefried; Madhuri Kakarala; Angela Brodie; Nathan A Berger Journal: Cancer Prev Res (Phila) Date: 2012-10-03
Authors: Rebecca N Jerome; Meghan Morrison Joly; Nan Kennedy; Jana K Shirey-Rice; Dan M Roden; Gordon R Bernard; Kenneth J Holroyd; Joshua C Denny; Jill M Pulley Journal: Drug Saf Date: 2020-06 Impact factor: 5.606