Re: GYN: WHI - HRT and Colorectal Cancer
From: Efrain Ramirez (eramirezt@coqui.net)
Thu Mar 4 17:54:03 2004
This WHI thing it's getting out of hands - one of these days an
epidemiologist will extract some data that will "prove" that ERT is
associated with an increase risk of nightmares of "Freddy vs. Jason" --
and savings up to $100 per year/patient of Charmin due to a decrease in
BM's -- uf!!
>At Thu, 4 Mar 2004, art fougner, md wrote:
>
>Estrogen plus Progestin and Colorectal Cancer in Postmenopausal Women
>
>Rowan T. Chlebowski, M.D., Ph.D., Jean Wactawski-Wende, Ph.D., Cheryl
>Ritenbaugh, Ph.D., M.P.H., F. Allan Hubbell, M.D., M.S.P.H., Joao
>Ascensao, M.D., Ph.D., Rebecca J. Rodabough, M.S., Carol A. Rosenberg,
>M.D., Victoria M. Taylor, M.D., M.P.H., Randall Harris, M.D., Ph.D.,
>Chu Chen, Ph.D., Lucile L. Adams-Campbell, Ph.D., Emily White, Ph.D.,
>for the Women's Health Initiative Investigators
>
>ABSTRACT
>
>Background Although the Women's Health Initiative (WHI) trial of
>estrogen plus progestin in postmenopausal women identified more overall
>health risks than benefits among women in the hormone group, the use of
>estrogen plus progestin was associated with a significant decrease in
>the risk of colorectal cancer. We analyzed features of the colorectal
>cancers that developed and their relation to the characteristics of the
>participants.
>
>Methods In the WHI trial, 16,608 postmenopausal women who were 50 to 79
>years of age and had an intact uterus were randomly assigned to a
>combination of conjugated equine estrogens (0.625 mg per day) plus
>medroxyprogesterone acetate (2.5 mg per day) or placebo. The main
>outcome measures were the incidence, stages, and types of colorectal
>cancer, as determined by blinded central adjudication.
>
>Results There were 43 invasive colorectal cancers in the hormone group
>and 72 in the placebo group (hazard ratio, 0.56; 95 percent confidence
>interval, 0.38 to 0.81; P=0.003). The invasive colorectal cancers in
>the hormone group were similar in histologic features and grade to those
>in the placebo group but with a greater number of positive lymph nodes
>(mean ±SD, 3.2±4.1 vs. 0.8±1.7; P=0.002) and were more advanced
>(regional or metastatic disease, 76.2 percent vs. 48.5 percent;
>P=0.004). In exploratory analyses, women in the hormone group with
>antecedent vaginal bleeding had colorectal cancers with a greater number
>of positive nodes than women in the hormone group who did not have
>vaginal bleeding (3.8±4.3 vs. 0.7±1.5 nodes, P=0.006).
>
>Conclusions Relatively short-term use of estrogen plus progestin was
>associated with a decreased risk of colorectal cancer. However,
>colorectal cancers in women who took estrogen plus progestin were
>diagnosed at a more advanced stage than those in women who took placebo.
>
>New England Journal of Medicine Volume 350:991-1004 March 4, 2004
>
>art
>
>--
>art fougner, md
>ich bin ein New Yorker
>
--
"The opposite of a correct statement is a false statement.
But the opposite of a profound truth may well be another profound truth."
Niels Bohr (1885 - 1962)
