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Experts Weigh in on Hormone Therapy

Risks & Benefits of Postmenopausal Use of Hormones

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VOLUME 2, ISSUE 8
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Colorectal Cancer


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The table below summarizes the available evidence on the risks and benefits of hormone therapy. Included are all randomized trials and meta-analyses looking at disease incidence or mortality. Inclusion of observational trials was dependent on size: case-control studies with 500 or more cases of the disease and cohort studies with at least 2,000 women are included here.

The year noted is when the study results were published. The name following the title of the study is the last name of the first author on the publication.

E = estrogen; P = progestin

Year

Study

Study Type

Participants

Hormones

Results

Other Notes

1995

MacLennan

Meta-analysis
(13 observational)

14 studies

E, E+P

No significant difference in relative risk of colorectal cancer in hormone users

No distinction between E vs. E+P use, or between colon vs. rectal cancer

1996

Persson

Cohort

22,597

E, E + P

Reduction in colon cancer risk by 40% with E + P

No effect with estrogen; 13 years of follow-up

1999

Grodstein (A)

Meta-analysis (17 observational; 1 randomized)

18 studies

E, E+P

Decreases colon cancer risk 20%; decreases rectal cancer risk 19%

No distinction between E vs. E+P use

1999

Nanda

Meta-analysis (24 observational, 1 randomized)

25 studies

E, E+P

33% reduction of risk in recent users (within year of study); ever-use reduced risk 8%

No distinction between E vs. E+P use; rectal cancer not affected by hormone use

2002

Women's Health Initiative

Randomized

16,608

E+P

37% reduction in colon cancer rates

Average follow-up 5.2 years


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