Newsletter - October 2002
US trial of HRT terminated early
Part of the Women’s Health Initiative, the largest randomized trial of hormone replacement therapy ever conducted, was stopped prematurely in July 2002 (Writing Group for the Women’s Health Initiative Investigators, JAMA 2002; 288: 321-333). The main reason reported for stopping was that the trial showed more harm than benefit with use of combined oestrogen plus progestagen HRT. Women randomised to HRT experienced significantly higher rates of breast cancer, coronary heart disease, stroke and thrombosis and significantly lower rates of colorectal cancer and hip fracture than women randomised to placebo; however, the harmful effects outweighed the beneficial ones. A recent review of the evidence on HRT from randomised trials to date finds an overall increase in breast cancer, stroke and pulmonary embolism in users which is not offset by reductions in colorectal cancer and hip fracture, (Beral V, Banks E, Reeves G. Lancet 2002; 360: 942-44).
These findings highlight the importance of studies like the Million Women Study in addressing unanswered questions, especially those relating to the effect of the different types of HRT on various health outcomes, the effect of HRT on the risk of death from various causes and on the risk of rarer conditions, such as cancer of the ovary.
Cervix cancer
The Million Women Study is expanding to include the investigation of factors affecting the risk of a woman having an abnormal cervical smear and her risk of cervix cancer. Factors to be examined include reproductive factors, lifestyle and use of hormones such as the oral contraceptive pill and HRT.
The next Million Women Study Collaborators’ Meeting: a date for your diaries
The next Million Women Study Collaborators’ meeting will take place on the 16th June 2003 at Lincoln’s Inn Fields, London. Invitations to the meeting will be sent out closer to the time.
New web address
The Million Women Study has a new web address which is considerably easier to remember than the last one! Go to:
www.millionwomenstudy.org
for the latest information on the study.
New publications
There are two new publications from the Million Women Study; the first indicates women who attend breast cancer screening come from less deprived areas and are more likely to use HRT than non-attenders, but are similar in terms of use of other prescription medications. The second paper investigates the factors relating to the risk of a “false positive” breast cancer screen and demonstrates the importance of a woman’s screening history, menopausal status and previous breast operations in influencing this risk. The references are as follows:
Comparison of various characteristics of women who do and do not attend for breast cancer screening. Banks E, Beral V, Cameron R, Hogg A, Langley N, Barnes I, Bull D, Reeves G, English R, Taylor S, Elliman J, Harris CL. Breast Cancer Research 2002;4 (1):R1.1-R1.6
Predictors of outcome of mammography in the National Health Service Breast Screening Programme. Banks E, Reeves G, Beral V, Bull D, Crossley B, Simmonds M, Hilton E, Bailey S, Barrett N, Rockall L, Wallis MG, Wilson M. Journal of Medical Screening 2002; 9 (2): 74-82
