Healthy Skepticism Library item: 7056
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Publication type: news
Miller B.
New research renews hormone, cancer link debate
PM - Transcript 2006 Dec 15
http://www.abc.net.au/pm/content/2006/s1812888.htm
Abstract:
MARK COLVIN: New research from the US has reignited the debate on the use of hormone replacement therapy by menopausal women.
The study, by researchers from the University of Texas, found rates of the most common form of breast cancer dropped 15 per cent from August 2002 to December 2003.
That happened to be when widely publicised research suggested that HRT increased the risk of breast cancer and the authors are suggesting there is a strong connection.
But some experts say the study has serious limitations.
This report from Barbara Miller.
BARBARA MILLER: The University of Texas researchers described their findings as astounding. They say the explanation that the significant drop in breast cancer rates is due to the drop in HRT usage is perfect.
The trouble is that they didn’t specifically study whether there was a causal relationship between the drop in HRT usage and the drop in breast cancer rates, but only inferred it.
Dr Helen Zorbas is Director of the Australian National Breast Cancer Centre.
She welcomes the new study, but says it’s just a starting point.
HELEN ZORBAS: I think it’s a fascinating piece of information that will be interesting to try and unravel.
It is difficult to understand what the complexities might be that have brought around this decrease in incidence, which of course is a really wonderful and welcome piece of data and we hope that we can say the same in Australia when we have the 2003 data here.
However there may be other factors that have affected the population in the United States that could impact on risk and maybe HRT is part of that story but perhaps not the whole story.
BARBARA MILLER: Susan Davis is Professor of Women’s Health at Monash University in Melbourne.
She says the finding of the US study may not reflect a drop in breast cancer incidence, but in detection of the disease.
SUSAN DAVIS: Was that because less women were taking HRT? Well that is a bit suspicious because, you know, if something is going to cause breast cancer and you stop it for six months, that effect is not likely to go away that fast, that’s one thing.
There may be a number of things causing this and one of the things we really need to look at is if women stop their HRT, were they less likely to attend their doctor in the next 12 months and have their breasts checked, and less likely to go for a breast screening?
If women stop going to breast screen as commonly, then what we’re going to see is a reduction in rates of diagnosis immediately.
BARBARA MILLER: The Director of the New South Wales Breast Cancer Institute is also urging caution.
John Boyages says the conclusion that less HRT means less breast cancer is superficial.
He says even if there is a risk associated with HRT, some women may decide it’s worth it, at least for the short-term.
JOHN BOYAGES: If a large population of women are all taking HRT, or if they’re all smoking, then obviously a little bit of risk for all of them, may translate in an increased risk at a population level of maybe five per cent, maybe seven per cent.
But for an individual woman who, for example, may be aged 52, going through a terrible menopause, then, we’ve worked out that short-term HRT may increase her risk of breast cancer, from 6.1 in 100, 6.1 per cent to 6.4 per cent, if she took it for five years.
So, a woman like that might say look, well .3 of a per cent is really not all that bad, and I might consider taking one, two, three years of HRT, but the important message is try not to take it for more than five years in particular.
MARK COLVIN: Professor John Boyages of the New South Wales Breast Cancer Institute ending that report from Barbara Miller.
