An analysis of ovarian cancer in the Million Women Study

Abstract

In a reanalysis of the Million Women Study (MWS), their authors concluded that prolonged use of hormone replacement therapy (HRT) in postmenopausal women increases the risk of ovarian cancer. Although statistically significant their results are clinically irrelevant, since the attributable risk over 5 years is only 4 per 10 000 HRT users, a figure that is not confirmed by other large studies. This risk is much lower than those associated with obesity, lack of physical exercise, smoking and nulliparity, all of which are preventable. Therefore HRT should continue to be prescribed for symptom relief and improvement of quality of life because the benefits far outweigh the very low potential risks.

Association of Ovarian and Uterine Cancers With Postmenopausal Hormonal Treatments

“…6,7 Therefore, HT should continue to be prescribed for symptom relief and improvement of quality of life because the benefits far outweigh the very low potential risks. 4 Uterine Cancer CERVIX Although the major concern with uterine cancer is the endometrium, the cervix is not unaffected by HT as viral expression (human papillomavirus) may increase, thus subsequently increasing risk for cancer. Past users had a significantly higher risk using combination HT regimens with increasing duration [adjusted odds ratio (OR) = 1.8/y; 95% CI = 1.1-1.3].…”

“…The risk is much lower than that associated with obesity, lack of physical exercise, smoking, and nulliparity, all of which are preventable. 4 The MWS has been severely criticized. The risk of ovarian cancer was no longer increased once women stopped using HT, an effect that was pathologically and clinically incompatible with causation.…”