閉経後のエストロゲン補充療法により卵巣癌増加?
2002/4/2 全くホルモン療法を受けてない人に比べて、エストロゲンと間欠的なプロゲステロンを用いている人は卵巣癌が多くなるが、ほんのわずかであるため治療をやめる必要はない。エストロゲンとプロゲステロンを常に併用している人は増えないと。
Hormone Therapy Linked to Risk of Ovarian Cancer
Tue Apr 2, 5:39 PM ET
NEW YORK (Reuters Health) - Certain types of hormone replacement
therapy may increase the risk of ovarian cancer in women who take
the drugs after menopause, according to a study released on Tuesday.
Those taking the drugs for more than 10 years seem to be at the
greatest risk for ovarian cancer.
However, the increase in risk is relatively modest and should
be weighed against the potential health benefits of hormone replacement,
according to Dr. Tomas Riman, from Falu Hospital, Sweden, and
colleagues. Past studies have shown that hormone replacement therapy
can reduce the risk of bone-thinning, and possibly heart disease,
though that has not yet been proven.
"We advocate cautious interpretation of our results and do
not recommend changes to current hormone replacement therapy prescribing
practices," Riman and colleagues report in the April 3rd
issue of the Journal of the National Cancer Institute (news -
web sites).
"For women to make an informed decision on whether or not
to use hormone replacement therapy, all beneficial and adverse
hormonal aspects concerning osteoporosis, coronary heart disease,
venous thrombosis (blood clot formation) and other health effects
must be addressed," they add.
In the study, the researchers compared 655 women with ovarian
cancer to nearly 4,000 healthy women the same age. All the women
were 50 to 74 years of age.
Compared with women who had never used estrogen replacement therapy,
women who took estrogen alone were at increased risk of ovarian
cancer.
Women who used estrogen with sequentially added progestins--a
cyclic regimen of the second hormone--were also at an increased
risk of ovarian cancer compared with women who had never used
estrogen.
However, women who used hormone replacement therapy with continuously
(daily) added progestins were no more likely to develop ovarian
cancer than those who never had used hormones. Taking estrogen
alone is know to increase the risk of cancer of the uterine lining,
so most women now also take progestin, a synthetic form of the
hormone progesterone, as part of hormone replacement therapy.
The greatest increased risk of ovarian cancer was seen among women
who had used estrogen with sequentially added progestins for more
than 10 years.
However, the researchers note that the possible increase in risk
is still relatively modest. Of 1,000 women taking estrogen alone
or in combination with sequential progestin, 2 to 3 might develop
ovarian cancer as a result of the treatment.
SOURCE: Journal of the National Cancer Institute 2002;94:497-504.