Angela M. Cheung, MD, PhD
In postmenopausal women, what are the health risks and benefits over 2 years after stopping estrogen and progestin therapy?
Randomized placebo-controlled trial (Women's Health Initiative [WHI] trial).
{Concealed}†.*
Blinded (participants, clinicians, {data collectors, outcome assessors, and safety committee}†).*
Mean 2.4 years after stopping therapy.
40 clinical centers in the US.
16 608 postmenopausal women 50 to 79 years of age with an intact uterus. 15 730 women (mean age 63 y) were included in the postintervention phase.
Conjugated equine estrogen (CEE), 0.625 mg/d, plus medroxyprogesterone acetate (MPA), 2.5 mg/d (n = 8052), or placebo (n = 7678).
Included all-cause mortality; cardiovascular (CV) events (coronary heart disease [CHD], revascularization, stroke, and thromboembolism); cancer (invasive breast, endometrial, colorectal, and all); fractures; and a global index.
95% (intention-to-treat analysis).
During the postintervention phase, the CEE plus MPA group had higher risk for all cancers than did the placebo group (Table). Groups did not differ for all-cause mortality, CV events, invasive breast cancer, colorectal cancer, or global index (Table); or CHD, thromboembolism, endometrial cancer, or fractures.
Postmenopausal women had increased risk for cancer, but not cardiovascular or global risk, over 2 years after stopping estrogen and progestin therapy.
Conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA) vs placebo in postmenopausal women‡
‡Abbreviations defined in Glossary. RRI, NNH, and CI calculated from control event rates and hazard ratios in article.
§Coronary heart disease, stroke, deep venous thrombosis, pulmonary embolism, or revascularization.
||Coronary heart disease, breast cancer, endometrial cancer, colorectal cancer, stroke, pulmonary embolism, hip fracture, and all-cause mortality.
Cheung AM. Risk for cancer was still increased over 2 years after stopping hormone therapy. Ann Intern Med. ;149:JC2–11. doi: 10.7326/0003-4819-149-4-200808190-02011
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© 2019
Published: Ann Intern Med. 2008;149(4):JC2-11.
DOI: 10.7326/0003-4819-149-4-200808190-02011
Cancer Screening/Prevention, Hematology/Oncology, Prevention/Screening.
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