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Menopause, hormone replacement therapy and cancer
C La Vecchia1, L A Brinton, A McTiernan
1Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milan, Italy. epidemiology@marionegri.it
Maturitas
|August 22, 2001
Summary
Hormone replacement therapy (HRT) may increase breast cancer risk, especially with prolonged use, but effects diminish after cessation. Cyclic combined HRT may reduce endometrial cancer risk, but individual risk factors are crucial for prolonged use decisions.
Area of Science:
- Oncology
- Endocrinology
- Epidemiology
Background:
- Hormone replacement therapy (HRT) is used for menopausal symptoms.
- Its association with various cancer risks requires comprehensive review.
Purpose of the Study:
- To review available evidence on the relationship between HRT and cancer risk.
- To synthesize findings on breast, endometrial, and other cancers.
Main Methods:
- Qualitative literature review of epidemiological data.
- Analysis of observational studies on HRT use and cancer incidence.
Main Results:
- HRT use, particularly current and recent, is linked to a moderate increase in breast cancer risk, escalating with duration but decreasing post-cessation.
- Unopposed estrogen HRT is associated with endometrial cancer, while cyclic combined HRT with adequate progestin may mitigate this risk.
- Combined HRT might elevate breast cancer risk compared to unopposed estrogens; HRT shows an inverse association with colorectal cancer, though causality is debated. No clear links to ovarian, liver, or lung cancers were found.
Conclusions:
- Individualized recommendations for prolonged HRT are essential.
- Consideration of breast cancer risk factors (family/personal history) and other chronic disease risks is vital.