Another cancer associated with hormone replacement therapy
>
> The use of hormone replacement therapy (HRT) by women during and following
> menopause has recently been found to be linked with an elevated risk of
> breast and endometrial cancer, as well as failing to protect against
> cardiovascular disease. A large study published in the March 21 2001 issue
> of the Journal of the American Medical Association shows that hormone
> replacement appears to increase the risk of ovarian cancer as well.
> Ovarian cancer is usually detected in its late stages making it difficult
> to treat.
>
> The study utilized data from the American Cancer Society's Cancer
> Prevention Study II, which followed up participants for mortality from
> 1982 to 1996. Of the 676,526 people enrolled in this study who completed
> questionnaires in 1982, there were 211,581 postmenopausal cancer-free
> women who did not report a hysterectomy. During the fourteen year
> follow-up period, 944 members of this group succumbed to death from
> ovarian cancer.
>
> Twenty-two percent of the women reported noncontraceptive hormone
> replacement use on their questionnaires. The highest risk of ovarian
> cancer was found in women who had used hormone replacement therapy for ten
> or more years. This risk was present up to twenty-nine years after hormone
> replacement was discontinued. Those who were using hormone replacement the
> most recently experienced a higher risk than those who had previously used
> it. Women who had used HRT for less than ten years had a small but
> insignificant increased risk. The lowest risk of ovarian cancer was found
> in women who had never been on HRT, in whom an annual age-adjusted death
> rate from ovarian cancer was 26.4 per 100,000 women, compared to that of
> 64.4 for those who were on HRT at the beginning of the study and who had
> used it for ten or more years.
>
> The authors postulate two mechanisms of action for postmenopausal
> estrogen: decreased gonadotropins caused by elevated serum estradiol and
> estrone levels, or a direct effect of estrogen on ovarian cells. They
> state that if their results are confirmed, clinicians will need to add
> ovarian cancer to the list of longterm estrogen use risks.
>
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