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A Fatal Blow for HRT?

Postmenopausal women on combined estrogen/progestin hormone replacement therapy (HRT) are at increased risk of getting and dying from lung cancer, according to research published in the British medical journal The Lancet. The discovery adds to the already long list of risks associated with HRT and bolsters the case against its use for fighting such menopause-related ills as vaginal dryness and hot flashes.

Analyzing data from the U.S. government-sponsored Women's Health Initiative (WHI), researchers found that

after the 8 years total follow-up, more women died from lung cancer in the combined hormone therapy group than in the placebo group (73 vs 40 deaths; women in HRT group 71% more likely to die). This was mainly as a result of a higher number of deaths from non-small-cell lung cancer (NSCLC) in the combined therapy group (62 vs 31 deaths; women in HRT group 87% more likely to die specifically of NSCLC).

The WHI, a study of HRT use in more than 16,000 postmenopausal women that was launched in 1991, was halted early when it became apparent that the health risks associated with HRT outweighed the benefits. It showed women on HRT to be at increased risk of cardiovascular disease, coronary heart disease, stroke, venous thromboembolism and breast cancer (though at lower risk of fractures and colorectal cancers).

The authors of the Lancet study concluded that women already at high risk of lung cancer, by virtue of their being current smokers or former long-term smokers, should take that risk into account when considering HRT.

But an editorial accompanying the study takes that observation a step further. Apar Kishor Ganti of the University of Nebraska Medical Center in Omaha, Nebraska, writes:

Because the optimum safe duration of hormone-replacement therapy in terms of lung-cancer survival is unclear, such therapy should probably be avoided in women at a high risk of developing lung cancer, especially those with a history of smoking. These results, along with the findings showing no protection against coronary heart disease, seriously question whether hormone-replacement therapy has any role in medicine today.

By Jennifer LaRue Huget  |  September 19, 2009; 7:01 PM ET
Categories:  Women's Health  
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