In relatively healthy women , combined continuous HT significantly increased the risk of venous thrombo-embolism or coronary event ( after one year 's use ) , stroke ( after three years ) , breast cancer and gallbladder disease .
Long-term oestrogen-only HT significantly increased the risk of venous thrombo-embolism , stroke and gallbladder disease ( after one to two years , three years and seven years ' use respectively ) , but did not significantly increase the risk of breast cancer .
The only statistically significant benefits of HT were a decreased incidence of fractures and ( for combined HT ) colon cancer , with long-term use .
Among women aged over 65 who were relatively healthy ( i.e. generally fit , without overt disease ) and taking continuous combined HT , there was a statistically significant increase in the incidence of dementia .
Among women with cardiovascular disease , long-term use of combined continuous HT significantly increased the risk of venous thrombo-embolism .
AUTHORS ' CONCLUSIONS HT is not indicated for the routine management of chronic disease .
We need more evidence on the safety of HT for menopausal symptom control , though short-term use appears to be relatively safe for healthy younger women
BACKGROUND Hormone therapy ( HT ) is widely used for controlling menopausal symptoms and has also been used for the management and prevention of cardiovascular disease , osteoporosis and dementia in older women .
This is an up date d version of the original Cochrane review first published in 2005 .
OBJECTIVES To assess the effect of long-term HT on mortality , cardiovascular outcomes , cancer , gallbladder disease , cognition , fractures and quality of life .
Oestrogen plus progestin and lung cancer in postmenopausal women (Women's Health Initiative trial): a post-hoc analysis of a randomised controlled trial
BACKGROUND In the post-intervention period of the Women 's Health Initiative ( WHI ) trial , women assigned to treatment with oestrogen plus progestin had a higher risk of cancer than did those assigned to placebo . Results also suggested that the combined hormone therapy might increase mortality from lung cancer . To assess whether such an association exists , we undertook a post-hoc analysis of lung cancers diagnosed in the trial over the entire follow-up period . METHODS The WHI study was a r and omised , double-blind , placebo-controlled trial undertaken in 40 centres in the USA . 16 608 postmenopausal women aged 50 - 79 years with an intact uterus were r and omly assigned by a computerised , stratified , permuted block algorithm to receive a once-daily tablet of 0.625 mg conjugated equine oestrogen plus 2.5 mg medroxyprogesterone acetate ( n=8506 ) or matching placebo ( n=8102 ) . We assessed incidence and mortality rates for all lung cancer , small-cell lung cancer , and non-small-cell lung cancer by use of data from treatment and post-intervention follow-up periods . Analysis was by intention to treat . This study is registered with Clinical Trials.gov , number NCT00000611 . FINDINGS After a mean of 5.6 years ( SD 1.3 ) of treatment and 2.4 years ( 0.4 ) of additional follow-up , 109 women in the combined hormone therapy group had been diagnosed with lung cancer compared with 85 in the placebo group ( incidence per year 0.16%vs 0.13 % ; hazard ratio [ HR ] 1.23 , 95 % CI 0.92 - 1.63 , p=0.16 ) . 96 women assigned to combined therapy had non-small-cell lung cancer compared with 72 assigned to placebo ( 0.14%vs 0.11 % ; HR 1.28 , 0.94 - 1.73 , p=0.12 ) . More women died from lung cancer in the combined hormone therapy group than in the placebo group ( 73 vs 40 deaths ; 0.11%vs 0.06 % ; HR 1.71 , 1.16 - 2.52 , p=0.01 ) , mainly as a result of a higher number of deaths from non-small-cell lung cancer in the combined therapy group ( 62 vs 31 deaths ; 0.09%vs 0.05 % ; HR 1.87 , 1.22 - 2.88 , p=0.004 ) . Incidence and mortality rates of small-cell lung cancer were similar between groups . INTERPRETATION Although treatment with oestrogen plus progestin in postmenopausal women did not increase incidence of lung cancer , it increased the number of deaths from lung cancer , in particular deaths from non-small-cell lung cancer . These findings should be incorporated into risk-benefit discussion s with women considering combined hormone therapy , especially those with a high risk of lung cancer . FUNDING National Heart , Lung and Blood Institute , National Institutes of Health
In relatively healthy women , combined continuous HT significantly increased the risk of venous thrombo-embolism or coronary event ( after one year 's use ) , stroke ( after three years ) , breast cancer and gallbladder disease .
Long-term oestrogen-only HT significantly increased the risk of venous thrombo-embolism , stroke and gallbladder disease ( after one to two years , three years and seven years ' use respectively ) , but did not significantly increase the risk of breast cancer .
The only statistically significant benefits of HT were a decreased incidence of fractures and ( for combined HT ) colon cancer , with long-term use .
Among women aged over 65 who were relatively healthy ( i.e. generally fit , without overt disease ) and taking continuous combined HT , there was a statistically significant increase in the incidence of dementia .
Among women with cardiovascular disease , long-term use of combined continuous HT significantly increased the risk of venous thrombo-embolism .
AUTHORS ' CONCLUSIONS HT is not indicated for the routine management of chronic disease .
We need more evidence on the safety of HT for menopausal symptom control , though short-term use appears to be relatively safe for healthy younger women
BACKGROUND Hormone therapy ( HT ) is widely used for controlling menopausal symptoms and has also been used for the management and prevention of cardiovascular disease , osteoporosis and dementia in older women .
This is an up date d version of the original Cochrane review first published in 2005 .
OBJECTIVES To assess the effect of long-term HT on mortality , cardiovascular outcomes , cancer , gallbladder disease , cognition , fractures and quality of life .