Newsletter - November 2004
Million Women Study Publications
Three more papers have been published this year: one on fractures, and two on the efficiency and effectiveness of mammography in hormone replacement therapy (HRT) users.
Fractures and HRT
Based on nearly 3 years’ follow-up of 140 000 postmenopausal women recruited between 1996 and 1998, Million Women Study findings published in May 2004 (JAMA 2004; 291: 2212-2220) confirmed that current users of HRT have fewer new fractures than women not taking HRT. We were able to show that protection against fractures was similar for different types of HRT (oestrogen only, combined oestrogen-progestagen, and other types including tibolone) and different doses of hormones, but that protection disappeared within a year of stopping HRT use. For most women the increased risk of breast cancer and stroke will outweigh this benefit of HRT.
Mammography is less sensitive and less specific in HRT users
Two papers (BMJ May 2004;328:1291-1292 and BMJ Aug 2004;329:477-479), based on mammographic screening in the Million Women Study, have confirmed that mammography is both less sensitive and less specific for detection of breast cancer in women taking HRT. Similar results were found for different types and doses of HRT. This effect of HRT is probably related to increased breast density, and seems to last for some years after HRT use has stopped. One result is an increased risk of false positive recall within the Breast Screening Programme; another is that cancers are less likely to be detected at screening, and more likely to present as interval cancers.
New premises: the Richard Doll Building
The Million Women Study will be moving to brand new premises next year as the Radcliffe Infirmary closes. The Richard Doll Building, at the Churchill Hospital site in Oxford, will bring the Cancer Research UK Epidemiology Unit together with the Clinical Trial Service Unit and other public health and epidemiology departments of Oxford University. Work on the building, by Nicholas Hare Architects, is nearing completion.
The Richard Doll Building
2005: Next Collaborator’s meeting
We hope to be settled in the new building by summer 2005, ready to host the next Collaborators’ meeting in the autumn. We will send out details nearer the time.
Thank you to screening clinic staff
Moya Simmonds, Elizabeth Hilton and Barbara Crossley would like to thank screening clinic staff for their help during the collection of data for 2002-2003, giving details of breast cancers that have developed in the ladies who returned our questionnaires in those long ago days when you were all kind enough to send them out. We were very grateful then to be treated so well when we were causing you extra work, and even happier this year when you made us so welcome in spite of again causing work for the Office Managers and disruption for the rest of the offices. We enjoyed meeting familiar faces, and some new ones, and thank you for all your help.
Impact of the Million Women Study
Our paper on breast cancer and HRT was the most downloaded paper in the Lancet for 2003 and is much quoted. The results of the Million Women Study have already influenced prescribing policy in the UK; we hope that future results will continue to help inform the debate on HRT use.
