Hormones can raise breast cancer risk

[Kris]

By MIKE STOBBE, AP Medical Writer
Thu Apr 19, 7:55 AM ET



ATLANTA - Research on two continents signaled more bad news for menopause hormones, offering the strongest evidence yet that they can raise the risk of breast cancer and are tied to a slightly higher risk of ovarian cancer.

New U.S. government numbers showed that breast cancer rates leveled off in 2004 after plunging in 2003 — the year after millions of women stopped taking hormones because a big study tied them to higher heart, stroke and breast cancer risks. Experts said the leveling off shows that the 2003 drop in the cancer rate was real and not a fluke.

From 2001 to 2004, breast cancer rates fell almost 9 percent — a dramatic decline, researchers report in Thursday's New England Journal of Medicine. The trend was even stronger for the most common form of the disease — tumors whose growth is fueled by hormones. Those rates fell almost 15 percent among women ages 50 to 69, the group most likely to have been on hormone pills.

At the same time, a study of nearly 1 million women in the United Kingdom showed that those who took hormones after menopause were 20 percent more likely to develop ovarian cancer or die from it than women who never took the pills. That study was published online by the London-based journal The Lancet.

For consumers, the new research doesn't change the advice to use the lowest dose for the shortest time possible for hot flashes and other menopause symptoms that can't otherwise be controlled.

For cautious scientists, the new breast cancer numbers were more evidence of the hormone-breast cancer link.

"The story has gotten stronger," said Dr. Peter Ravdin, a biostatistician at the University of Texas M.D. Anderson Cancer Center in Houston who led the research.

Some were skeptical several months ago when Ravdin and National Cancer Institute researchers first reported the 2003 drop in the breast cancer rate. The new numbers, which add 2004, prove this was no fluke, said Dr. Julie Gralow, a spokeswoman for the American Society of Clinical Oncology and cancer expert at the University of Washington in Seattle.

"Because it didn't bump back up again," it supports the idea that the rate has stabilized at a new lower level, said Gralow, who had no role in the study.

Brenda Edwards, one of the journal authors who is a National Cancer Institute researcher, agreed. "Now we have a statistically significant decline" over three years and clear proof of a trend, she said.

Although some recent analyses suggest heart risks from menopause hormones are not as great as had been believed for younger, newly menopausal women, the statistics out this week add to the worries about cancer.

After rising steadily through the 1990s, the breast cancer rate dipped from 2001 to 2002, from 138 cases to 135 cases per 100,000 women. After the federal Women's Health Initiative study reported in July 2002 on the health risks of hormones, use of the pills plunged.

So did the breast cancer rate the following year — to 126 cases per 100,000 women. It was the steepest fall since the government started keeping records in the 1970s.

The drop was seen in all of the cancer statistics registries reviewed in the study, and no other cancer rate changed as dramatically — strong signs that hormones were playing a role, specialists said.

The 2004 rate held steady at about 126 cases per 100,000.

Stopping hormone use may have stopped some cancers from growing and caused them to disappear, scientists speculate. Or it may have just slowed them down so that they won't appear until years later, said Ahmedin Jemal, an American Cancer Society researcher. Only time will tell which is true, he said.

Wyeth Pharmaceuticals, which makes top-selling hormone pills Prempro and Premarin, criticized the study as overly speculative. Company spokesman Dr. Joseph Camardo said hormone prescriptions continued to fall in 2004 but breast cancer rates did not decline proportionately.

Ravdin said the company's criticism does not invalidate the cancer trends.

Breast cancer is the most common major cancer in American women and the second leading cause of cancer deaths in women. About 180,000 new cases are expected to occur in the United States this year and more than 1 million worldwide.

Ovarian cancer is far less common. The British study found that even with the 20 percent greater risk from hormones, the actual risk was very low: 2.6 of every 1,000 hormone users developed ovarian cancer over five years compared to 2.2 in 1,000 non-hormone users.

Still, that means about 1,000 extra ovarian cancer deaths from 1991 through 2005, said study leaders at the Cancer Research UK Epidemiology Unit in Oxford.

Hormone use has declined already, and the new report should cause it to fall further, Dr. Steven Narod of the University of Toronto wrote in an editorial accompanying the study in The Lancet.

"We hope that the number of women dying of ovarian cancer will decline as well," he wrote.

Camardo, Wyeth's spokesman, said hormone labels already warn about an elevated risk of ovarian cancer.

[intenshn]

Doing GS scares me because of that..yet here I am, trying for GS #4. I have definately noticed that it makes your lining more active though. I started developing uterine polyps after my 3rd GS, but luckily they were small and easy to remove. I'm confident they wouldn't have formed had I not had so many regimens of hormones.

I like being pregnant so much though, that it's kind of an addiction I imagine. People know that cigarettes cause lung cancer and other forms of cancer, but they continue to smoke anyway because its addictive.

this has been on the news an awful lot lately over here as well-esp with the HRT....its scarey as not all women are physically able to cope without the aid of HRT,then to make it worse they say that you need to stay on it for anything between 5-12 years dependant on your own personal circumstances.
it certainly makes me think about that little sticky patch i stick on my bum every 3days----am i just putting myself into an early grave??
its scarey to think we are told to use these things,yet they can now try to link it with -LUNG CANCER-ENDOMETRIAL CANCER-BREAST CANCER,plus there are others as well.....

heres another recent article...

"A retrospective study examining the impact of HRT on the natural history of lung cancer has been published early online in the Journal of Clinical Oncology.The authors conclude from their data that HRT may adversely affect lung cancer outcomes and further studies are urgently needed to help clarify this risk.
Researchers collected data retrospectively from a chart review of 498 women (median age,67 years;range,31 to 93 years),diagnosed with lung cancer between January 1994 & December 1999. The use of HRT was defined to include all forms of hormone replacement,including either combination oestrogen & progestin or oestrogen alone for at least 6 continuous weeks before the diagnosis of lung cancer.Women who had a history of remote use of HRT for at least 6 weeks were also considered to have used HRT for the purpose of this study.
The following main results were reported:
• 86 women (17%) had taken HRT for at least 6 continuous weeks before the development of lung cancer.
• A history of smoking was present in 429 women (86%)
• Women with lung cancer who received HRT were younger than women with lung cancer who never received HRT (median age 63 vs 68 years, respectively; p < 0.0001).
• Overall survival was statistically significantly higher in patients not on HRT vs those on HRT (79 vs 39 months, respectively; hazard ratio = 1.97; 95% CI, 1.14 to 3.39).
• Women who smoked & used HRT had a worse overall survival compared with women who smoked,but did not use HRT(median survival,39 months vs 73 months,respectively; p = 0.03).
• Overall survival was lower in non-smoking women who used HRT vs those who did not use HRT (median survival,92 vs 98 months,respectively),however,this difference was not statistically significant.
The researchers acknowledge that the retrospective nature of the study did not allow them to determine the type of HRT used,the total duration of HRT use,& usage after the diagnosis of lung cancer.
An accompanying editorial notes that although the study is not definitive because of the limitations mentioned above,“the data strongly suggest that HRT use should be discontinued after a lung cancer diagnosis.This would also be consistent with recent studies suggesting that HRT cannot protect against other conditions such as heart disease & osteoporosis to the extent hoped.Additional research examining the type of HRT used,& duration & timing of use,on lung cancer diagnosis and survival,is clearly warranted.”
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