C La Vecchia1, L A Brinton, A McTiernan. 1. Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milan, Italy. epidemiology@marionegri.it
Abstract
OBJECTIVE: To comparatively review available evidence on hormone replacement therapy (HRT) and cancer. METHODS: Qualitative literature review. RESULTS: Most potential favorable and adverse effects on cancer risk of HRT are restricted to current users. On the basis of observational epidemiological data, the RR of breast cancer is moderately elevated in current and recent HRT users, and increases by about 2.3% per year with longer duration of use, but the effect drops after cessation and largely, if not totally, disappears after about 5 years. Unopposed estrogen use is strongly related to endometrial cancer risk, but cyclic combined oestrogen-progestin treatment appears to largely or totally reduce this side effect, if progestin are used for at least 14 days per cycle. However, combined HRT may be associated with higher risk of breast cancer as compared to unopposed estrogens. HRT has been inversely related to colorectal cancer, although the issue of causal relation remains open to discussion. No consistent association was reported for ovarian, liver, other digestive or lung cancer. CONCLUSIONS: Recommendations for prolonged HRT use must be considered on an individual basis, taking into account the presence of other risk factors mainly for breast cancer, such as family history of breast cancer or a personal history of benign breast disease, as well as individual risk for other chronic diseases.
OBJECTIVE: To comparatively review available evidence on hormone replacement therapy (HRT) and cancer. METHODS: Qualitative literature review. RESULTS: Most potential favorable and adverse effects on cancer risk of HRT are restricted to current users. On the basis of observational epidemiological data, the RR of breast cancer is moderately elevated in current and recent HRT users, and increases by about 2.3% per year with longer duration of use, but the effect drops after cessation and largely, if not totally, disappears after about 5 years. Unopposed estrogen use is strongly related to endometrial cancer risk, but cyclic combined oestrogen-progestin treatment appears to largely or totally reduce this side effect, if progestin are used for at least 14 days per cycle. However, combined HRT may be associated with higher risk of breast cancer as compared to unopposed estrogens. HRT has been inversely related to colorectal cancer, although the issue of causal relation remains open to discussion. No consistent association was reported for ovarian, liver, other digestive or lung cancer. CONCLUSIONS: Recommendations for prolonged HRT use must be considered on an individual basis, taking into account the presence of other risk factors mainly for breast cancer, such as family history of breast cancer or a personal history of benign breast disease, as well as individual risk for other chronic diseases.
Authors: Leonardo Alfonso Bustamante-Lopez; Sergio Carlos Nahas; Caio Sergio R Nahas; Rodrigo Ambar Pinto; Carlos Frederico S Marques; Ivan Cecconello Journal: Arq Bras Cir Dig Date: 2019-12-20
Authors: Lonneke A van Tuijl; Adri C Voogd; Alexander de Graeff; Adriaan W Hoogendoorn; Adelita V Ranchor; Kuan-Yu Pan; Maartje Basten; Femke Lamers; Mirjam I Geerlings; Jessica G Abell; Philip Awadalla; Marije F Bakker; Aartjan T F Beekman; Ottar Bjerkeset; Andy Boyd; Yunsong Cui; Henrike Galenkamp; Bert Garssen; Sean Hellingman; Martijn Huisman; Anke Huss; Melanie R Keats; Almar A L Kok; Annemarie I Luik; Nolwenn Noisel; N Charlotte Onland-Moret; Yves Payette; Brenda W J H Penninx; Lützen Portengen; Ina Rissanen; Annelieke M Roest; Judith G M Rosmalen; Rikje Ruiter; Robert A Schoevers; David M Soave; Mandy Spaan; Andrew Steptoe; Karien Stronks; Erik R Sund; Ellen Sweeney; Alison Teyhan; Ilonca Vaartjes; Kimberly D van der Willik; Flora E van Leeuwen; Rutger van Petersen; W M Monique Verschuren; Frank Visseren; Roel Vermeulen; Joost Dekker Journal: Brain Behav Date: 2021-09-02 Impact factor: 2.708