Literature DB >> 33813609

What is behind the fear of cancer during menopausal hormone therapy in China?

Yanfang Wang1, Wei Wang2, Ying Feng3, Zhangyun Tan4, Xiaomin Yang5, Danhong Peng6, Yinqing Zhao4, Han Dong7, Qingmei Zheng8, Xiaoqin Zeng9, Ying Zou10, Aijun Sun11.   

Abstract

PURPOSE: The application of menopausal hormone therapy (MHT) is generally restricted most likely due to limited prescriptions by doctors. Fear of cancer risk may be a critical factor. We investigated the views of Chinese obstetricians and gynecologists on the relationship between hormone therapy and cancer risk.
METHODS: A self-administered web-based nationwide cross-sectional questionnaire.
RESULTS: In total, 5243 medical workers responded to the questionnaire (response rate 94.5%); 4995 were certified obstetricians and gynecologists. Most were aged 36-55 years (70.9%), had > 10 years of working experience (68.5%), and worked at tertiary (34.8%) and secondary hospitals (49.1%); 70% of the clinicians were aware of the endometrial cancer risk caused by estrogen, and 20% considered progestogen to cause the same risk. Regarding breast cancer, while 67.9 and 74.8% of the clinicians viewed natural and synthetic estrogens as risk factors, respectively, only 41.7% identified the carcinogenic effect of progestins as higher than that of progesterone (26.7%). Approximately 75% of the participants believed synthetic estrogens and progestins constituted a risk for ovarian cancer (higher than the percentages for their natural counterparts); 13.0-21.1% of the respondents were worried about choriocarcinoma due to hormone treatment. Finally, 86.8% of obstetricians and gynecologists claimed to have poor knowledge regarding this field.
CONCLUSION: Misconceptions and a lack of knowledge in this regard may result in the fear of cancer and could be the underlying causes of limited MHT prescriptions. We believe that scientific research, continued education, and the media all have roles to play in changing preconceived ideas regarding MHT prescriptions.

Entities:  

Keywords:  Cancer risk; Knowledge; Menopausal hormone therapy; National survey; Obstetrician and gynecologist

Year:  2021        PMID: 33813609     DOI: 10.1007/s00404-021-06052-4

Source DB:  PubMed          Journal:  Arch Gynecol Obstet        ISSN: 0932-0067            Impact factor:   2.344


  33 in total

1.  Increased risk of endometrial carcinoma among users of conjugated estrogens.

Authors:  H K Ziel; W D Finkle
Journal:  N Engl J Med       Date:  1975-12-04       Impact factor: 91.245

Review 2.  A "window of opportunity:" the reduction of coronary heart disease and total mortality with menopausal therapies is age- and time-dependent.

Authors:  Howard N Hodis; Wendy J Mack
Journal:  Brain Res       Date:  2010-10-25       Impact factor: 3.252

3.  Risks and benefits of hormone therapy: has medical dogma now been overturned?

Authors:  S Shapiro; T J de Villiers; A Pines; D W Sturdee; R J Baber; N Panay; J C Stevenson; A O Mueck; H G Burger
Journal:  Climacteric       Date:  2014-04-23       Impact factor: 3.005

4.  Revised global consensus statement on menopausal hormone therapy.

Authors:  T J de Villiers; J E Hall; J V Pinkerton; S Cerdas Pérez; M Rees; C Yang; D D Pierroz
Journal:  Maturitas       Date:  2016-06-16       Impact factor: 4.342

5.  Duration of menopausal vasomotor symptoms over the menopause transition.

Authors:  Nancy E Avis; Sybil L Crawford; Gail Greendale; Joyce T Bromberger; Susan A Everson-Rose; Ellen B Gold; Rachel Hess; Hadine Joffe; Howard M Kravitz; Ping G Tepper; Rebecca C Thurston
Journal:  JAMA Intern Med       Date:  2015-04       Impact factor: 21.873

Review 6.  A woman's journey through the reproductive, transitional and postmenopausal periods of life: impact on cardiovascular and musculo-skeletal risk and the role of estrogen replacement.

Authors:  John C Stevenson
Journal:  Maturitas       Date:  2011-07-23       Impact factor: 4.342

7.  Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial.

Authors:  Louise Lind Schierbeck; Lars Rejnmark; Charlotte Landbo Tofteng; Lis Stilgren; Pia Eiken; Leif Mosekilde; Lars Køber; Jens-Erik Beck Jensen
Journal:  BMJ       Date:  2012-10-09

8.  Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial.

Authors:  Jacques E Rossouw; Garnet L Anderson; Ross L Prentice; Andrea Z LaCroix; Charles Kooperberg; Marcia L Stefanick; Rebecca D Jackson; Shirley A A Beresford; Barbara V Howard; Karen C Johnson; Jane Morley Kotchen; Judith Ockene
Journal:  JAMA       Date:  2002-07-17       Impact factor: 56.272

9.  Menopausal hormone use and ovarian cancer risk: individual participant meta-analysis of 52 epidemiological studies.

Authors:  V Beral; K Gaitskell; C Hermon; K Moser; G Reeves; R Peto
Journal:  Lancet       Date:  2015-02-13       Impact factor: 79.321

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  1 in total

Review 1.  Effects of transdermal versus oral hormone replacement therapy in postmenopause: a systematic review.

Authors:  Marina Šprem Goldštajn; Mislav Mikuš; Filippo Alberto Ferrari; Mariachiara Bosco; Stefano Uccella; Marco Noventa; Peter Török; Sanja Terzic; Antonio Simone Laganà; Simone Garzon
Journal:  Arch Gynecol Obstet       Date:  2022-06-17       Impact factor: 2.344

  1 in total

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