Menopausal Hormone Therapy and the Risk of Cancer

Fellow: Sara Nafisi

Cancer is the top cause of death in Norway and second globally, with nearly 10 million deaths in 2020. Menopausal hormone therapy (MHT) is used to relieve menopausal symptoms by supplementing estrogen and is considered a potential risk factor for cancer. However, research results are inconsistent. This leads to uncertainty about the use of MHT and leaves many women to suffer through menopause with untreated symptoms such as hot flushes and sleep difficulties. Most large studies on MHT and cancer risk come from the USA, which may not be directly applicable to Norway due to different demographics and MHT use. Additionally, most studies have short follow-up periods and lack comprehensive data on key factors like age at menarche and menopause, BMI, lifestyle, and MHT duration. This project aims to assess cancer risks (breast, colon/rectum, lung, skin, endometrial, ovarian) associated with MHT use in Norway, using high-quality data from national registries in Norway.

Collaborators and supervisors:

1. Iqbal Ahmad Abdelwahab Al-Zirqi (PhD): The project leader and main supervisor, (Specialist in Gynaecology, Fellow of the Royal College of Obstetricians and Gynaecologist - FRCOG, UK), senior researcher at the Norwegian Research Centre for Women’s Health and consultant obstetrician/ gynaecologist at Oslo University Hospital, Division of Gynaecology and Obstetrics, Rikshospitalet. She has extensive knowledge regarding the medical aspects of cancer and MHT through her many years of clinical experience in different countries such as Kuwait, England and Norway. She has good experience in analysing big registries.
2. Siri Vangen (PhD): Co-supervisor, professor (Specialist in Gynaecology), leader and senior researcher at the Norwegian Research Centre for Women’s Health (Oslo University Hospital). She has extensive experience with epidemiologic research and the use of population-based registry data. She participated in the study group establishing the linked data file of prescriptions and cancer. She will contribute to the study based on her experience from previous publications about MHT and cancer using similar types of data. 
3. Nathalie C. Støer (PhD): Co-supervisor, Biostatistician at the Cancer Registry of Norway. She has extensive experience in cancer epidemiology, especially pharmacoepidemiology, and a strong methodological background. She will contribute with her methodological experience and detailed knowledge of the Norwegian registries linked together in addition to biostatistics. 
4. Edoardo Botteri (PhD): Co-supervisor, Biostatistician and epidemiologist at the Cancer Registry of Norway. He has strong experience in cancer epidemiology, with a focus on lifestyle factors and pharmacoepidemiology. He will offer his experience in cancer epidemiology and biostatistics. 
5. Denise Reis Costa (PhD): Co-supervisor, Researcher/Statistician at the Norwegian Research Centre for Women’s Health, and Postdoctoral Researcher at the Cancer Registry of Norway/Norwegian Institute of Public Health. Her research explores the use of new cancer drugs in melanoma treatment, and she has extensive experience in data handling and statistical analysis with the development of open-source statistical packages.