HRT Heightens Risk For Lung Cancer

Women—especially those at high risk for lung cancer—should be informed that hormone replacement therapy (HRT) using estrogen and progestin increases the risk of death from lung cancer. These are the conclusions of a recent study by Rowan T. Chlebowski, MD, PhD, and colleagues (Lancet. 2009; 374[9697]:1243-1251).

Dr Chlebowski and his coinvestigators examined data from the Women's Health Initiative trial, which evaluated estrogenplus-progestin HRT in 16 608 postmenopausal women aged 50 to 79 years with an intact uterus. Half the participants (8506 women) received either a oncedaily tablet of 0.625 mg conjugated equine estrogen plus 2.5 mg medroxyprogesterone acetate, and the remainder (8102) were given matching placebo. The trial was halted in July 2002 after a mean follow-up of 5.6 years revealed that compared to women taking the placebo, women assigned to HRT had higher risks of cardiovascular disease, coronary heart disease, stroke, venous thromboembolism, and breast cancer (but lower risks of fractures and colorectal cancers).

In the current study, Dr Chlebowksi's team found that after a total follow-up period of 8 years, more women died from lung cancer in the combined hormone therapy group (73 deaths) than in the placebo group (40 deaths). The risk of death was 71% higher for the hormone users. The main driver of these mortality rates was non-small-cell lung cancer (NSCLC), which accounted for 62 deaths in the combined therapy group—double the 31 deaths among the women taking placebo. According to the researchers, women in the HRT group were 87% more likely to die specifically of NSCLC than were the placebo users.

“Treatment with [estrogen] plus progestin in postmenopausal women…increased the number of deaths from lung cancer,” they wrote. “These findings should be incorporated into risk-benefit discussions with women considering combined hormone therapy, especially those with a high risk of lung cancer…such as current smokers or longterm past smokers.”

Source: Oncology Nursing News

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