The WHI investigators did not expect to find an increased overall risk of cancer after stopping the estrogen plus progestin, Heiss said. The increased risk is small, but the follow up did indicate there are higher levels of breast cancer, lung cancer, stroke and death among those who had taken this therapy. Thus, there is a need for prevention efforts through healthy lifestyle choices, risk factor control and regular screening activities as recommended by health care practitioners. This is good advice for everyone though, whether they have taken estrogen plus progestin for 3.5 to 8.5 years as in this study or not.
A summary of the risks and benefits (called the global index) included outcomes for coronary heart disease, invasive breast cancer, stroke, pulmonary embolism, endometrial cancer, colorectal cancer, hip fracture and death due to other causes. The researchers found that this measure was 12 percent higher in women randomly assigned to receive estrogen plus progestin compared with the placebo, and did not visibly change after the intervention was stopped.
The rates of colorectal cancer did not differ significantly between the two groups and rates of endometrial cancer were lower in the estrogen plus progestin group.
The risk of cardiovascular events was comparable between the two groups in the follow up assessment, Heiss said, meaning that the increased risks seen in women assigned to estrogen plus progestin during the trial period weakened after the study drugs were stopped.
The risk of fractures during the postintervention follow-up was similar among women in both groups for each type of fracture considered: hip, vertebral and other osteoporotic fractures.
The follow-up after stopping estrogen plus progestin use confirms the trials main conclusion that combination hormone therapy should not be used t
|Contact: Patric Lane|
University of North Carolina at Chapel Hill