Menopausal therapy associated with higher cancer risk

Women using menopause hormone therapy (MHT) face an increased risk of breast cancer, with this increased risk lasting for more than a decade after they stop using it.

This is according to a new study conducted by the University of Oxford.

‘One in every 50 users of HRT’ to develop disease

The researchers found that five years of MHT, beginning at the age of 50, would increase the incidence of breast cancer until the age of 69 by roughly one additional case in every 50 users of oestrogen plus daily progestogen MHT.

Meanwhile, cases of breast cancer would increase by one in every 70 users of oestrogen plus intermittent progestogen MHT, and one in every 200 users of oestrogen-only MHT.

After ceasing MHT, some excess risk was found to persist for more than 10 years. The size of this risk depended on the duration of previous use.

If a woman had used MHT for less than a year, however, there was little excess risk after stopping.

The researchers worked out that six in every 100 women not taking menopausal hormone therapy would develop breast cancer between the ages of 50 and 69. But if they took oestrogen and progestogen daily for five years, eight women would go on to develop the disease.

Previous estimates of risks doubled

Study co-author Professor Valerie Beral, University of Oxford, said: “Our new findings indicate that some increased risk persists even after stopping use of menopausal hormone therapy. Previous estimates of risks associated with use of menopausal hormone therapy are approximately doubled by the inclusion of the persistent risk after use of the hormones ceases.”

The researchers said that in Western countries, the use of MHT increased rapidly during the 1990s, halved abruptly in the early 2000s, then stabilised during the 2010s.

Currently, there are approximately 12 million users in Western countries, with one million of those in the UK. Although some are short-term users, about five years of use is now common. Previously, roughly 10 years of use was typical.

Overall, the use of MHT was more strongly associated with oestrogen-receptor-positive (ER+) breast cancer than with other types of breast cancer. This is because hormonal factors mainly affect ER+ breast cancer.

The increased risk of developing ER+ breast cancer accounted for most of the excess breast cancer risk associated with MHT.

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