Andreas Stang1. 1. Sektion Klinische Epidemiologie, Institut für Medizinische Epidemiologie, Biometrie und Informatik, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Strasse 8, Halle, Germany. andreas.stang@medizin.uni-halle.de
Abstract
INTRODUCTION: Between 2002 and 2003 the incidence of invasive breast cancer among women aged 50 to 69 years declined considerably in the US. This decline was accompanied by a substantial fall in prescription rates of estrogen-progestin (EG-HRT). METHODS: Selective literature search in PubMed from 01/2003 to 12/2007 using the key words "hormone replacement therapy," "incidence," and "breast cancer." RESULTS: The parallel decline in EG-HRT and breast cancer suggests a causal link. Up to now, alternative explanations for the decline of the incidence can either be refuted or revealed as implausible. DISCUSSION: Detailed incidence trend analyses in the coming years and a close monitoring of EG-HRT prescription rates in and beyond the US. promise important insights. If EG-HRTs are carcinogenic, the extent of this effect remains unclear. If cessation of EG-HRT therapy only delays the appearance of detectable breast cancer, a long-term increase in incidence would be expected in women of age 50 and older, even with low prescription rates. However, if cessation of EG-HRT also stops tumor growth, the anticipated incidence will be permanently lower in the future.
INTRODUCTION: Between 2002 and 2003 the incidence of invasive breast cancer among women aged 50 to 69 years declined considerably in the US. This decline was accompanied by a substantial fall in prescription rates of estrogen-progestin (EG-HRT). METHODS: Selective literature search in PubMed from 01/2003 to 12/2007 using the key words "hormone replacement therapy," "incidence," and "breast cancer." RESULTS: The parallel decline in EG-HRT and breast cancer suggests a causal link. Up to now, alternative explanations for the decline of the incidence can either be refuted or revealed as implausible. DISCUSSION: Detailed incidence trend analyses in the coming years and a close monitoring of EG-HRT prescription rates in and beyond the US. promise important insights. If EG-HRTs are carcinogenic, the extent of this effect remains unclear. If cessation of EG-HRT therapy only delays the appearance of detectable breast cancer, a long-term increase in incidence would be expected in women of age 50 and older, even with low prescription rates. However, if cessation of EG-HRT also stops tumor growth, the anticipated incidence will be permanently lower in the future.
Entities:
Keywords:
breast cancer; cancer registry; epidemiology; hormone replacement therapy; mammography
Authors: Theresa H M Keegan; Ellen T Chang; Esther M John; Pamela L Horn-Ross; Margaret R Wrensch; Sally L Glaser; Christina A Clarke Journal: Breast Cancer Res Date: 2007-09-25 Impact factor: 6.466
Authors: Peter M Ravdin; Kathleen A Cronin; Nadia Howlader; Christine D Berg; Rowan T Chlebowski; Eric J Feuer; Brenda K Edwards; Donald A Berry Journal: N Engl J Med Date: 2007-04-19 Impact factor: 91.245
Authors: Karla Kerlikowske; Diana L Miglioretti; Diana S M Buist; Rod Walker; Patricia A Carney Journal: J Natl Cancer Inst Date: 2007-08-14 Impact factor: 13.506