Hormone Replacement Therapy risk

Oxford Scientists Reported Risk of Using Hormone Replacement Therapy in 1987 / "Why Weren't Women Told?", asks Coalition on Abortion/Breast Cancer

In 1987, Oxford University scientists authored a paper for the British Journal of Obstetrics and Gynaecology demonstrating the risk of using hormone replacement therapy (HRT), said the Coalition on Abortion/Breast Cancer. [1]  Their cohort study of 4,544 women reported a significant 59% increase in risk among those who used HRT (mean duration of use 67 months). Forty-three percent used combined HRT containing estrogen and progestin.

At the San Antonio Breast Cancer Conference, Peter Ravdin and his colleagues reported a 7% drop in breast cancer cases primarily among women over age 50 for the year 2003.  They attributed it to a decline in HRT use. [2]

"Why weren't women told in 1987 about the risk of using HRT?" asked Karen Malec, president of the Coalition.  "Breast cancer rates would have declined sooner." 

Cancer authorities didn't warn women about HRT risks until 2002 when the Women's Health Initiative study reported that its use increases the risks of breast cancer, heart attack and strokes. [3]

"Women have the right to know that combined oral contraceptives (OCs) contain the same drugs as combined HRT, but OCs have an even larger dose," argued Malec.

Oxford scientists reported in 1987 that women who use OCs multiply their breast cancer risk by 2.6 times. [8]

The World Health Organization classified both drugs as Group 1 carcinogens in 2005. [4,5]  A scientific review in the journal Mayo Clinic Proceedings found a 44% risk increase among women who used OCs before a first full term pregnancy. [6] 

Sadly, the risk of using OCs remains widely unknown, especially among the most cancer-vulnerable group - childless teenagers and young women.  Some take OCs for medically innocuous reasons like acne, menstrual cramps and irregular menstrual periods.

"In light of these facts, how can women believe cancer authorities when they deny an abortion-breast cancer link, especially when the biological basis for all three risks is the same?" asked Malec. [7]

The Coalition's medical adviser, Professor Joel Brind of the Breast Cancer Prevention Institute, asked:

"Why should (the sudden drop in HRT use) be reflected in lower cancer rates only one year later?  The answer is the mechanism by which HRT increases risk, i.e., by stimulating the growth of abnormal cells already present; cells which might never progress to actual cancers without the growth-promoting effect of HRT.  In contrast, were large numbers of (much younger) women to stop taking contraceptive steroids or having abortions, the effect would probably not show up for 8 to 10 years, and it would appear first among premenopausal, rather than postmenopausal, women."

The Coalition on Abortion/Breast Cancer is an international women's organization founded to protect the health and save the lives of women by educating and providing information on abortion as a risk factor for breast cancer.

References

1. Hunt K, Vessey M, McPherson K, Coleman M. Br J Obstet Gynaecol 1987;94(7):620-635. Available at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=3620411&query_hl=1&itool=pubmed_docsum.

2. See abstract from the San Antonio Breast Cancer Symposium. Ravdin PM, Cronin KA, Howlander N, Chlebowski RT, Berry DA.. MD Anderson; National Cancer Institute; Harbor UCLA Medical Center. A sharp decrease in breast cancer incidence in the United States in 2003. Available at: http://www.abstracts2view.com/sabcs06/view.php?nu=SABCS06L_766.

3. Writing group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA 2002;288:321-33.

4. Cogliano V, Grosse Y, Baan R, Secretan B, El Ghissassi F. Carcinogenicity of combined oestrogen-progestagen contraceptives and menopausal treatment. Lancet Oncology 2005;6:552-553.

5. Press Release No. 167, "IARC Monographs Programme Finds Combined Estrogen-Progestogen Contraceptives (the "pill") and Menopausal Therapy Are Carcinogenic to Humans," World Health Organization International Agency for Research on Cancer, July 29, 2005. See http://www.iarc.fr/ENG/Press_Releases/pr167a.html.

6. Kahlenborn C, Modugno F. Potter D, Severs W. Oral contraceptive use as a risk factor for premenopausal breast cancer: A meta-analysis. Mayo Clinic Proceedings 2006;81(10):1290-1302. Available at:
http://www.mayoclinicproceedings.com/pdf/8110/8110a1.pdf.

7. For a discussion of the biological reasons for the abortion-breast cancer link, see a paper by Angela Lanfranchi, MD at: 

8. McPherson K, et al. Early oral contraceptive use and breast cancer: Results of another case control study.  Br J Cancer 1987;56:653-660.  Available at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=3426932&query_hl=4&itool=pubmed_docsum.

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