HRT and breast cancer risk

Rymer, Janice; Brian, Kate; Regan, Lesley

doi:10.1136/bmj.l5928

Cited by 12 publications

(28 citation statements)

References 8 publications

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“…Other unknowns include questions about breast cancer survival rates and all cause mortality in women using HRT. 13 …”

Section: Discussionmentioning

confidence: 99%

“…Knowing the cancer stage could also address the question of risk differences between women of various body weights, to clarify whether systematic differences might exist in diagnostic delay. Other unknowns include questions about breast cancer survival rates and all cause mortality in women using HRT 13…”

Section: Discussionmentioning

confidence: 99%

“…At publication, the focus of publicity was the higher than expected associations with breast cancer risks than had been suggested by earlier trials. The Medicine and Healthcare products Regulatory Agency subsequently raised an HRT drug safety alert specific to breast cancer, but this has since been questioned as having caused “considerable anxiety,” particularly for women who might need HRT for reasons other than menopausal symptoms 13…”

Section: Introductionmentioning

confidence: 99%

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Use of hormone replacement therapy and risk of breast cancer: nested case-control studies using the QResearch and CPRD databases

Vinogradova

Coupland

Hippisley‐Cox

2020

BMJ

138

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Objective To assess the risks of breast cancer associated with different types and durations of hormone replacement therapy (HRT). Design Two nested case-control studies. Setting UK general practices contributing to QResearch or Clinical Practice Research Datalink (CPRD), linked to hospital, mortality, social deprivation, and cancer registry (QResearch only) data. Participants 98 611 women aged 50-79 with a primary diagnosis of breast cancer between 1998 and 2018, matched by age, general practice, and index date to 457 498 female controls. Main outcome measures Breast cancer diagnosis from general practice, mortality, hospital, or cancer registry records. Odds ratios for HRT types, adjusted for personal characteristics, smoking status, alcohol consumption, comorbidities, family history, and other prescribed drugs. Separate results from QResearch or CPRD were combined. Results Overall, 33 703 (34%) women with a diagnosis of breast cancer and 134 391 (31%) controls had used HRT prior to one year before the index date. Compared with never use, in recent users (<5 years) with long term use (≥5 years), oestrogen only therapy and combined oestrogen and progestogen therapy were both associated with increased risks of breast cancer (adjusted odds ratio 1.15 (95% confidence interval 1.09 to 1.21) and 1.79 (1.73 to 1.85), respectively). For combined progestogens, the increased risk was highest for norethisterone (1.88, 1.79 to 1.99) and lowest for dydrogesterone (1.24, 1.03 to 1.48). Past long term use of oestrogen only therapy and past short term (<5 years) use of oestrogen-progestogen were not associated with increased risk. The risk associated with past long term oestrogen-progestogen use, however, remained increased (1.16, 1.11 to 1.21). In recent oestrogen only users, between three (in younger women) and eight (in older women) extra cases per 10 000 women years would be expected, and in oestrogen-progestogen users between nine and 36 extra cases per 10 000 women years. For past oestrogen-progestogen users, the results would suggest between two and eight extra cases per 10 000 women years. Conclusion This study has produced new generalisable estimates of the increased risks of breast cancer associated with use of different hormone replacement preparations in the UK. The levels of risks varied between types of HRT, with higher risks for combined treatments and for longer duration of use.

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“…Other unknowns include questions about breast cancer survival rates and all cause mortality in women using HRT. 13 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of hormone replacement therapy and risk of breast cancer: nested case-control studies using the QResearch and CPRD databases

Vinogradova

Coupland

Hippisley‐Cox

2020

BMJ

138

View full text Add to dashboard Cite

show abstract

“…The recent publication of the individual patient data metaanalysis of the Collaborating Group on Hormonal Factors in Breast Cancer provided useful and, to some extent, novel insight regarding hormone replacement therapy (HRT) and breast cancer risk [1]. However, scientists and organizations around the world critiqued the paper both on social media and in the press, reigniting the debate on HRT and breast cancer [2][3][4][5].…”

mentioning

confidence: 99%

“…The recent meta-analysis [1] provided an extensive supplement, explaining the methods for calculating the absolute risk changes. Nevertheless, most editorials pointed out that this analysis made the interpretation of the results more perplexing [2,3,5]. An essential piece of information that the meta-analysis did not provide the reader with, is a measure of uncertainty regarding the change in the absolute risk, such as the 95 % confidence intervals (CI) [13].…”

mentioning

confidence: 99%