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| |  Hormone Replacement Therapy Increases Risk of Death From Lung Cancer NEW YORK -- September 24, 2009 -- Hormone replacement therapy (HRT) using oestrogen and progestin increases the risk of death from lung cancer, according to a study published online first and in an upcoming edition of The Lancet. This finding should be incorporated into risk-benefit discussions for women considering HRT, especially those at high risk of lung cancer. Rowan Chlebowski, Los Angeles Biomedical Research Institute at Harbour-UCLA Medical Center, Torrance, California, and colleagues looked at data from the Women’s Health Initiative (WHI) trial. The trial was stopped early when health risks were found to exceed benefits. The trial included 16,608 postmenopausal women aged 50 to 79 years with an intact uterus who received either a once-daily tablet of 0.625 mg conjugated equine oestrogen plus medroxyprogesterone acetate 2.5 mg (n = 8,506) or matching placebo (n = 8,102). At a mean follow-up of 5.6 years, participants assigned to HRT had higher risks of cardiovascular disease, coronary heart disease, stroke, venous thromboembolism, and breast cancer, and lower risks of fractures and colorectal cancers than did women assigned to placebo. All-cause mortality did not differ between study groups. Results from further follow-up (an additional 2.4 years, 8 years in total) also suggested that the combined hormone therapy might increase mortality from lung cancer. To assess whether such an association exists, the authors looked at the number of lung cancers diagnosed in the trial over the entire follow-up period. The researchers found that, after the 8 years total follow-up, more women died from lung cancer in the combined hormone therapy group than in the placebo group (73 vs 40 deaths; women in HRT group 71% more likely to die). This was mainly as a result of a higher number of deaths from non-small-cell lung cancer (NSCLC) in the combined therapy group (62 vs 31 deaths; women in HRT group 87% more likely to die specifically of NSCLC). Women in the HRT group were also 28% more likely to be diagnosed with lung cancer than those given placebo, although this finding was not statistically significant. Incidence and mortality rates of small-cell lung cancer were similar between groups. “Treatment with oestrogen plus progestin in postmenopausal women...increased the number of deaths from lung cancer, in particular deaths from non-small-cell lung cancer,” the authors concluded. “These findings should be incorporated into risk-benefit discussions with women considering combined hormone therapy, especially those with a high risk of lung cancer...such as current smokers or long-term past smokers.”
SOURCE: The Lancet
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