Hormone replacement therapy

[Guest guest]

Hi All,

Here is from this week’s Lancet. It available as PDFs including Lancet

articles referenced to.

It is an analysis of previous studies on hormone replacement and risks. It

suggests the thumb is down, I think. Although obviously more directly

pertinent to women, I believe that CRONies who are advised to take

testosterone or take male hormones run similar risks.

Lancet Oncol 2002; 3: 565-74

Rapid review Evidence from randomised trials on the long-term effects of

hormone replacement therapy

Beral, Banks, Gillian Reeves

Lancet 2002; 360: 942-44

“….. Starting point

Four randomised trials including over 20 000 women followed up for 4·9

years, on average, have now reported on the effect of HRT for major,

potentially fatal, conditions. Overall, HRT users had a significantly

increased incidence of breast cancer, stroke, and pulmonary embolism; a

significantly reduced incidence of colorectal cancer and fractured neck of

femur; but no significant change in endometrial cancer or coronary heart

disease. There was no significant variation across the trials in the results

for any condition. Three trials had recruited women with previous

cardiovascular disease and the fourth, the Women's Health Initiative, had

recruited healthy women. Combined oestrogen/progestagen HRT was used in

three trials and oestrogen alone in one. Use of HRT over a 5-year period by

healthy postmenopausal women in western countries is estimated to cause an

extra breast cancer, stroke, or pulmonary embolus in about 6 per 1000 users

aged 50-59 and 12 per 1000 aged 60-69. Over the same period, the estimated

reduction in incidence of colorectal cancer or fractured neck of femur is

1·7 per 1000 users aged 50-59 and 5·5 per 1000 aged 60-69. The increased

incidence of any one of these conditions is greater than any reduction, the

estimated net excess over 5 years being 1 per 230 users aged 50-59, and 1

per 150 aged 60-69.

Where next

Substantial new data should soon be available from randomised trials of

oestrogen-alone HRT versus placebo, whereas few additional trial data on

combined HRT are expected for about a decade. Existing randomised trials

are too small to describe reliably the effect of HRT on important but rarer

conditions, such as ovarian cancer, or on cause-specific mortality. Nor

will they provide information about other types of oestrogen or

progestagen. Answers to such questions will require judicious analysis and

interpretation of data from observational studies….”

I also saw but am almost sure I previous posted “You are what you eat” from

Lancet Oncology. If I did not, please correct me.

Cheers, Al.

Alan Pater, Ph.D.; Faculty of Medicine; Memorial University; St. 's, NF

A1B 3V6 Canada; Tel. No.: (709) 777-6488; Fax No.: (709) 777-7010; email:

apater@...