Survey: doctors overestimate HT's risks, benefits.(Gynecology)

WHITE SULPHUR SPRINGS, W.VA. -- Most physicians who prescribe hormone therapy still overestimate both its long-term risks and benefits, R. Stan Williams, M.D., said at the annual meeting of the South Atlantic Association of Obstetricians and Gynecologists.

Compared with internists and family doctors, ob.gyns. were the most likely to display an accurate understanding of these issues. But a large portion still gave incorrect answers to Dr. Williams' statewide physician survey on hormone therapy (HT).

"These people thought they understood the results of the Women's Health Initiative [WHI] and said they were counseling their patients about it, but only 28% of their answers were correct," said Dr. Williams, professor of ob.gyn of the University of Florida, Gainesville, and chief of the university's division of reproductive endocrinology and infertility.

"Most respondents (67%) dramatically overestimated the risks and benefits," and 5% of the answers "were actually in the wrong direction; they thought it was a risk when it was actually a benefit," he said.

In March 2004, Dr. Williams mailed his survey to all primary care physicians in Florida. The survey asked a specific question about the percentage of annual attributable change of risk of heart disease, stroke, venous thrombosis, breast cancer, colon cancer, hip fracture and death, as reported in the WHI.

He sent out more than 6,000 surveys; 600 were returned (203 from ob.gyns., 145 from internists, 219 from family physicians, and 33 from other physicians).

About 35% of ob.gyns., 30% of family physicians, and 17% of internists correctly answered that HT increased the risk of heart disease by less than 1% per year of use. Many thought there was no change in risk (35% of internists, 33% of ob.gyns, and 27% of family physicians). About 20% of internists and 15% of family physicians said the risk was increased 10%-30% per year of use.