Menopausal hormone therapy for primary prevention: why the USPSTF is wrong.

Area of Science:

• Menopausal Health
• Preventive Health Recommendations
• Endocrinology

Background:

• The US Preventive Services Task Force (USPSTF) issued a draft recommendation on Menopausal Hormone Therapy (MHT) in May 2017.
• The recommendation focuses on MHT for primary prevention of chronic diseases.
• This draft recommendation has been criticized for misinterpreting evidence and creating a disconnect with the affected population.

Purpose of the Study:

• To provide a comprehensive expert response to the USPSTF's draft recommendation statement on Menopausal Hormone Therapy.
• To address perceived misinterpretations of evidence regarding MHT, particularly concerning coronary heart disease and breast cancer.
• To advocate for a more rational discourse and prevent potential public health harm from the current draft recommendations.

Main Methods:

• An ad hoc group of experts in menopausal health reviewed the USPSTF draft recommendation.
• The experts analyzed the evidence cited by the USPSTF, focusing on data related to coronary heart disease and breast cancer.
• A comprehensive response was formulated and submitted to the USPSTF.

Main Results:

• The analysis identified a significant disconnect between the USPSTF's cited data and the population most affected by menopause.
• Major elements of the evidence, particularly concerning coronary heart disease and breast cancer, were found to be misinterpreted or misstated.
• There is no statistically significant evidence of harm from MHT for coronary heart disease and breast cancer.

Conclusions:

• The current USPSTF draft recommendations perpetuate outdated statements and risk causing public health harm.
• The expert response aims to correct misinterpretations and facilitate evidence-based discussions on Menopausal Hormone Therapy.
• A revised approach is needed to ensure recommendations accurately reflect the scientific evidence for MHT.