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UK Million Women Study From: art fougner, md (evsono@pipeline.com) Fri Apr 29 07:32:45 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: AGUS" Previous message: R. Daniel Braun: "Re: AGUS" The results of the UK "Million Women Study" on HRT and endometrial carcinoma are published in this weekend's edition of The Lancet: Findings: 320 953 women (45%) reported at recruitment that they had used HRT, among whom 69 577 (22%) last used continuous combined therapy (progestagen added daily to oestrogen), 145 486 (45%) last used cyclic combined therapy (progestagen added to oestrogen, usually for 10–14 days per month), 28 028 (9%) last used tibolone, and 14 204 (4%) last used oestrogen-only HRT. These HRT types had sharply contrasting effects on the overall risk of endometrial cancer (p<0·0001 for heterogeneity). Compared with never users of HRT, risk was: reduced with last use of continuous combined preparations (relative risk 0·71 [95% CI 0·56–0·90]; p=0·005); increased with last use of tibolone (1·79 [1·43–2·25]; p<0·0001) and oestrogen only (1·45 [1·02–2·06]; p=0·04); and not significantly altered with last use of cyclic combined preparations (1·05 [0·91–1·22]; p=0·5). A woman's body-mass index significantly affected these associations, such that the adverse effects of tibolone and oestrogen-only HRT were greatest in non-obese women, and the beneficial effects of combined HRT were greatest in obese women. Interpretation: Oestrogens and tibolone increase the risk of endometrial cancer. Progestagens counteract the adverse effect of oestrogens on the endometrium, the effect being greater the more days every month that they are added to oestrogen and the more obese that women are. However, combined oestrogen-progestagen HRT causes a greater increase in breast cancer than the other therapies do. Thus, when endometrial and breast cancers are added together, there is a greater increase in total cancer incidence with use of combined HRT, both continuous and cyclic, than with use of the other therapies. The entire article is freely available at: http://www.thelancet.com/journals/lancet/article/PIIS0140673605664550/fulltext art -- art fougner, md "If you don't know where you are going, you will wind up somewhere else." Lawrence Peter Berra Next message: art fougner, md: "Re: AGUS" Previous message: R. Daniel Braun: "Re: AGUS"

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