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Current Evidence of the Oncological Benefit-Risk Profile of Hormone Replacement Therapy

Academic Division of Gynaecology and Obstetrics, Mauriziano Hospital, University of Turin, 10128 Turin, Italy
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Medicina 2019, 55(9), 573; https://doi.org/10.3390/medicina55090573
Received: 28 June 2019 / Revised: 30 August 2019 / Accepted: 3 September 2019 / Published: 7 September 2019
(This article belongs to the Special Issue Hormone Replacement Therapy: Benefits and Risks)
Hormone replacement therapy (HRT) remains the most effective treatment for menopausal symptoms and has been shown to prevent bone loss and fracture. The progestogen is added to provide endometrial protection in women with an intact uterus. After the publication of the initial WHI (Women’s Health Initiative) results in 2002 reporting an overall increased risk of breast cancer, many women discontinued HRT. Despite the re-analysis of the results by subgroups of patients and updates with extended follow-up, much controversy remains, which we will analyze later in the text. Different types of estrogen or progestogen, as well as different formulations, doses, and durations, may play a role in HRT’s effects on breast tissue. Evidence states that conjugated equine estrogen (CEE), compared to estro-progestin therapy, shows a better profile risk (HR 0.79, CI 0.65–0.97) and that, among different type of progestins, those structurally related to testosterone show a higher risk (RR 3.35, CI 1.07–10.4). Chronic unopposed endometrial exposure to estrogen increases the risk of endometrial hyperplasia and cancer, whereas the association with progestins, especially in continuous combined regimen, seems to reduce the risk (RR 0.71, CI 0.56–0.90). HRT was also associated with a protective effect on colon cancer risk (HR 0.61, CI 0.42–0.87). Data about ovarian and cervical cancer are still controversial. View Full-Text
Keywords: menopause; hormone; women’s health, breast cancer; gynecological cancers; colon cancer menopause; hormone; women’s health, breast cancer; gynecological cancers; colon cancer
MDPI and ACS Style

D’Alonzo, M.; Bounous, V.E.; Villa, M.; Biglia, N. Current Evidence of the Oncological Benefit-Risk Profile of Hormone Replacement Therapy. Medicina 2019, 55, 573. https://doi.org/10.3390/medicina55090573

AMA Style

D’Alonzo M, Bounous VE, Villa M, Biglia N. Current Evidence of the Oncological Benefit-Risk Profile of Hormone Replacement Therapy. Medicina. 2019; 55(9):573. https://doi.org/10.3390/medicina55090573

Chicago/Turabian Style

D’Alonzo, Marta, Valentina E. Bounous, Michela Villa, and Nicoletta Biglia. 2019. "Current Evidence of the Oncological Benefit-Risk Profile of Hormone Replacement Therapy" Medicina 55, no. 9: 573. https://doi.org/10.3390/medicina55090573

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