Hormone replacement
therapy study halted
Increased risk of
breast cancer a factor, government says
WASHINGTON (CNN)
--In a move that may affect millions of women, U.S.
government scientists Tuesday stopped a major study of
hormone replacement therapy on the risks and benefits of
combined estrogen and progestin in healthy menopausal
women, citing an increased risk of invasive breast
cancer.
Researchers from the
National Heart, Lung and Blood Institute of the National
Institutes of Health also found increases in coronary
heart disease, stroke and pulmonary embolism.
The study further
clouds an issue that already was confusing for many
women. Contradicting research about the risks and
benefits of hormone replacement therapy has been
periodically released for years. The only consensus
among experts is that the decision is an individual one
since every woman's lifestyle issues and risk profile is
different.
"Women with a uterus
who are currently taking estrogen plus progestin should
have a serious talk with their doctor to see if they
should continue it," said Jacques Rossouw in a
statement. Rossouw is acting director of the Women's
Health Initiative, which sponsored the study.
"If they are taking
this hormone combination for short-term relief of
symptoms, it may be reasonable to continue since the
benefits are likely to outweigh the risks," Rossouw
continued. "Longer term use or use for disease
prevention must be re-evaluated."
A statement from the
institute noted the benefits of estrogen combined with
progestin, "including fewer cases of hip fractures and
colon cancer, but on balance the harm was greater than
the benefit."
About 6 million women
in the United States are taking estrogen and progestin
for various reasons, including relief of menopausal
symptoms and long-term use for the prevention of heart
disease and brittle bones.
The estrogen and
progestin trial study involved 16,608 women ages 50 to
79 with an intact uterus.
A major objective of
the trial study was to explore the effect of estrogen
and progestin on the prevention of heart disease and hip
fractures and any associated change in risk for breast
and colon cancer.
"We have long sought
the answer to the question: Does postmenopausal hormone
therapy prevent heart disease and, if it does, what are
the risks? The bottom-line answer from [the Women's
Health Initiative] is that this combined form of hormone
therapy is unlikely to benefit the heart," said Dr.
Claude Lenfant, director of the heart, lung and blood
institute, in a statement.
"The cardiovascular and
cancer risks of estrogen plus progestin outweigh any
benefits -- and a 26 percent increase in breast cancer
risk is too high a price to pay, even if there were a
heart benefit. Similarly, the risks outweigh the
benefits of fewer hip fractures.
"Menopausal women who
might have been candidates for estrogen plus progestin
should now focus on well-proven treatments to reduce the
risk of cardiovascular disease, including measures to
prevent and control high blood pressure, high blood
cholesterol and obesity," Lenfant continued.
In a statement, Garnet
Anderson, a biostatistician who led the analysis at the
Fred Hutchinson Cancer Research Center in Seattle,
Washington, said, "The trial was stopped at the first
clear indication of increased risk."
Anderson also said
that, at that point, there was no indication of
increased risk for breast cancer in the estrogen-only
group. |
