ERT Use Linked to Increased Risk of Ovarian Ca Mortality.

Women who use estrogen replacement therapy after menopause have up to 2.2 times the risk of dying from ovarian cancer, compared with women who never used the therapy.

Both length of estrogen use and, among former users, how recently they stopped ERT were important predictors of risk in a study of more than 200,000 women. The highest risk was seen in current users who had been on ERT for at least 10 years, reported Dr. Carmen Rodriguez and her colleagues at the American Cancer Society in Atlanta (JAMA 285[11]:1460-65, 2001).

"If our results are confirmed, clinicians will need to consider ovarian cancer among the health risks associated with 10 or more years of estrogen use," they said.

But the authors were quick to point out that a woman's lifetime risk of ovarian cancer is already low (1.7%) and that "any increase in risk of ovarian cancer mortality due to long-term estrogen use must be considered in the context of the overall balance of potential risks and benefits."

Dr. Lorraine Fitzpatrick, an endocrinologist at the Mayo Clinic in Rochester, Minn., agreed with that assessment.

"I don't think physicians should change their practice patterns, and I also don't think women should go off hormone replacement therapy because of this study" she told this newspaper.

The American Cancer Society's Cancer Prevention Study II was a prospective study of 211,581 postmenopausal women who completed a baseline questionnaire and were followed for 14 years. The questionnaire included questions about estrogen replacement use.