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HT may protect against colorectal cancer.(NEWS)
A 15-year observational study of almost 57,000 women has added more fuel to the hormone therapy fire, suggesting that postmenopausal hormone regimens can confer a significant and lasting reduction in the risk of colorectal cancer.
Although all regimens were associated with at least some decreased risk, the strongest was a 48% risk reduction among past users of estrogen plus progestin, Jill R. Johnson and her colleagues wrote. "Despite the recent decrease in use of all menopausal hormones, these results suggest an important protective effect of all hormone formulations, especially estrogen plus progestin, for the many women who continue to need and use menopausal hormone therapy," wrote Ms. Johnson of the University of Minnesota, Minneapolis (Cancer Epidemiol. Biomarkers Prev. 2009; 18: 196-203).
But Dr. JoAnn E. Manson, a principal investigator on the landmark Women's Health Initiative study, had a much more cautious outlook. 'Although the results are intriguing, it would be premature to recommend HT for the prevention of colorectal cancer," Dr. Manson, the Elizabeth F. Brigham Professor of Women's Health at Harvard Medical School, Boston, said in an interview. "In fact, I would advise against this, because long-duration HT confers a poor tradeoff in terms of cancer risk. A long" duration of treatment, especially [with] the combination estrogen plus progestin, substantially increases breast cancer risk and may even increase the risk of lung cancer. Thus, any benefits for colorectal cancer would be more than offset by increased risks of breast and other cancers." WHI found a 37% decreased risk of colorectal cancer among women who take combination HT, but no risk reduction in the estrogen-only arm.
The new study by Ms. Johnson used data extracted from the Breast Cancer Detection Demonstration Project, a screening initiative conducted from 1979 to 1998. The study cohort consisted of 56,733 postmenopausal women (mean age, 56 years at baseline). The 960 women who developed colorectal cancer were identified based on self-report, cancer registries, and the National Death Index.
Overall, the use of any HT regimen conferred a nonsignificant 9% decrease in the risk of colorectal cancer, compared with women who never took HT. But some significant results emerged when the risk rates were stratified by HT regimen.
There was a significant 17% decreased risk of colorectal cancer among women who had ever used unopposed ...
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