Another negative effect of hormone replacement therapy (HRT) in postmenopausal women has emerged: HRT has now been shown to increase the risk of death from non-small-cell lung cancer.

At yesterday’s meeting of the American Society for Clinical Oncology in Orlando, an analysis from the Women’s Health Initiative (WHI) was presented by UCLA’s Dr. Rowan Chlebowski. The WHI was a study of over 16,000 healthy postmenopausal women, in which half received HRT (estrogen + progesterone) while the other half received placebo. While there was not a significantly increased risk of getting non small cell lung cancer (NSCLC) in the HRT group, women who had NSCLC who were taking HRT were 60% more likely to die from the disease, compared to women who had NSCLC but were taking placebo.

For current smokers using HRT during the 8 year study, there was an excess risk of death of 1 in 100, compared to smokers not using HRT.

The WHI has previously shown that while HRT (with combined estrogen + progesterone) does decrease the risk of colon cancer and bone fractures, this is outweighed by the increased risk of heart attack, stroke, breast cancer and blood clots. Therefore, HRT is not generally recommended, unless it is required in the short term for severe menopausal symptoms, or for treatment of osteoporosis when other options are not feasible.

We can now add death from non-small-cell lung cancer to the list of risks of HRT. Because smoking is a risk factor for getting NSCLC, and because of the higher mortality of smokers in this study, smoking and HRT are clearly a bad combination.

 

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