Hi All

HRT research I could find is piecemeal, I was amazed that with such an important topic there would not be some definitive easily accessible answer.

Schairer C, Adami HO, Hoover R, Persson I., Cause-specific mortality in women receiving hormone replacement therap..Epidemiology. 1997 Jan;8(1):59-65. Environmental Epidemiology Branch, National Cancer Institute, Rockville, MD 20892-7374, USA. http://www.ncbi.nlm.nih.gov/pubmed/9116097

http://www.nhlbi.nih.gov/whi/estro_pro.htm This trial seems most widely quoted. It seems there are small but significant fatality rates. I would want to look at what bio markers/genomics lead to the increase. For instance would these woman have gotten cancer anyways but maybe a few of years later or are the hormones causative or contributary? The follow up evidence seems limited especially in regards to treatment.

Some studies say the breast cancers are not as severe but recent evidence suggests they are resistant to treatment. The lung cancer seems mostly small cell and I could not see survival rates. I think the study does not reflect earlier higher dose hormonal birth control many of these early adopters would have been on or  trials of early estrogen only projects, fertility treatments etc and the cumulative effect these could have on present treatment. Even weight could be a factor given the links between estrogens and fat. I would have liked to know obesity% and if this influenced outcomes with the addition of the hormones.   

In the trial below women taking HRT, 385 out of 8,506 developed breast cancer (4.5 percent), with 25 fatalities (0.29 percent). Placebo 293 of 8,102 developed breast cancer (3.6 percent), and 12 fatalities (0.15 percent).

Chlebowski RT, Anderson GL, Gass M, et al. Estrogen plus progestin and breast cancer incidence and mortality in postmenopausal women. Journal of the American Medical Association. 2010;304:1684-1692

Ovarian

Over five years, death rates in current and never-users were 1.6 (1.4-1.8) and 1.3 (1.2-1.4) per 1,000 respectively. These numbers amounted to one extra ovarian cancer death in roughly 3,300 users.

Beral V, et al "Ovarian cancer and hormone replacement therapy in the Million Women Study" Lancet 2007; doi:10.1016/S0140-6737(07) 60534-0

Narod SA ""Ovarian cancer and HRT in the Million Women Study" Lancet 2007; doi:10.1016/S0140-6736(07) 60535-2.

“During a total of about eight years of follow-up since the WHI study began, researchers found that the incidence of lung cancer was not increased in women who took HRT.

The percentages of women who died from lung cancer from the HRT group and the placebo group were low (0.11% and 0.06%), but statistically significant. When they looked at deaths due to lung cancer, they found 73 women who took HRT died of lung cancer compared with 40 in the placebo group. The researchers found this was mainly due to a higher number of deaths from non-small-cell lung cancer in the combined HRT group.”

Quoted directly from http://www.webmd.com/menopause/news/20090921/hrt-is-linked-to-deaths-from-lung-cancer

Best,

Amy

Amy Price

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