Abstract

PIP: 3 studies reviewed by the Federal Drug Administration (FDA) have concluded that new research affirms that menopausal and postmenopausal women who take estrogens have an increased risk of endometrial cancer. The data also supports estrogen labelling which advises health professionals and women patients that the risk is reduced if estrogens are taken in the lowest possible dose and if chronic administration is avoided. Increased risk of endometrial cancer in estrogen users is proportional to the duration of use and is particularly high with use over 5 years. Increased risk was reported for use of 1-5 years. Cyclic therapy or progestins for 7 days each month does not protect against the risk of endometrial cancer. Use of progestins for longer periods has not been proven to provide adequate protection and not been adequately studied. Women who have uterine bleeding after estrogen therapy receive increased diagnostic attention, and their cancer is detected earlier than women not taking the drugs. Although women with endometrial cancer who take estrogens may be diagnosed sooner, ultimately all women with endometrial cancer will be diagnosed. Estrogens are effective for vasomotor symptoms of the menopause and can be used with no known increase in risk for treatment if doses are kept low and duration is less than 1 year.