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Tue 1 May 2007 04:18 PM

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HRT study sounds alarm

Hormone replacement therapy has again been linked to breast and ovarian cancer, after a British study found HRT users were 20% more likely to die from ovarian cancer than woman who had never used HRT.

Hormone replacement therapy has again been linked to breast and ovarian cancer, after a British study found HRT users were 20% more likely to die from ovarian cancer than woman who had never used HRT.

The findings revealed that use of HRT for a minimum of five years resulted in 1,300 additional ovarian cancers over 14 years in Britain and 1,000 extra deaths.

Once women stopped taking HRT, however, their risk returned to that of never-users. In addition, no residual risk was seen in women who had taken HRT at some time in the past or for fewer than five years, said author Valerie Beral, MBBS, of the Cancer Research United Kingdom Epidemiology Unit, and colleagues.

"The effect of HRT on ovarian cancer should not be viewed in isolation, especially since use of HRT also affects the risk of breast and endometrial cancer," Beral's team wrote.

"The total incidence of these three cancers in the study population is 63% higher in current users of HRT than never users," they added.

"Thus when ovarian, endometrial and breast cancer are taken together, use of HRT results in a material increase in these common cancers."

The findings, taken from the UK-based Million Women Study, were published in the online edition of the
The Lancet

.

Ovarian cancer, the team note, is the fourth most common cancer in the United Kingdom with some 6,700 new cases every year. However, published results of the relationship between HRT and the risk of ovarian cancer have been inconclusive.

In an accompanying comment, Dr Steven A. Narod, of the University of Toronto, said the relative risk of HRT might be thought of as small, but enormous numbers of women have been exposed. In the Million Women Study alone, half a million women had taken HRT.

However, he said, because current use was found to be the main risk factor, the number of new cases attributable to HRT should be a function of the number of women taking the drug at any given time.

Use of hormone replacement, Narod said, has declined greatly in the UK as well as elsewhere since the 2003 report of the Women's Health Initiative, and is thought to be responsible for a recent reduction in breast cancer rates in the U.S.

"With these new data on ovarian cancer, we expect the use of HRT to fall further. We hope that the number of women dying of ovarian cancer will decline as well," Narod concluded.

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