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HRT May Up Lung Cancer Risk

Sep 22, 2009 | Parker Waichman LLP

Since the massive Women’s Health Initiative (WHI) study was initiated in 1991, an array of adverse effects has been associated with hormone replacement therapy (HRT). Now, WebMD is reporting that HRT has been linked to an increased risk of women dying from lung cancer.

The study, based on information collected during the WHI looked at women taking combined estrogen-plus-progesterone HRT (drugs like Wyeth's Prempro) and found that, versus women taking a placebo, the women on HRT experienced a 71 percent increased likelihood of dying from lung cancer. WebMD noted that the WHI was stopped when risks linked to HRT were found to outweigh its benefits. The WHI also found that women on combined HRT exhibited increased risks for heart disease and stroke, breast cancer, and other adverse health events.

WebMD pointed out that when the WHI study was halted, the risk of dying from any cause was not different between the groups studied; however, follow-up is now indicating an increased risk of lung cancer fatalities in those women who had taken combined HRT. "These findings should be considered before the initiation or continuation of combined hormone therapy in postmenopausal women, especially those with a high risk of lung cancer, such as current smokers or long-term past smokers," wrote researcher Rowan Chlebowski, MD, of the Los Angeles Biomedical Research Institute at Harbour-UCLA Medical Center in Torrance, California, and colleagues in The Lancet, quoted WebMD.

We have been following outcomes from the WHI and issues with HRT. Recently we wrote that while HRT has long been linked to female cancers and fatal blood clots, a more recent study concluded that women on HRT might be doubling their skin cancer risks. Another study revealed a connection with how HRT shrinks the brain. In addition to an increased risk of stroke and cerebrovascular disease in post-menopausal women on HRT, the WHI Memory Study also found that post-menopausal women on HRT suffered from a higher risk of dementia and memory problems.

Use of HRT plunged after the 2002 WHI study, which involved 16,608 post-menopausal women, was stopped. Research since also indicates that the incidence of breast cancer dropped by 8.6 percent between 2001 and 2004 in the United States, in conjunction with the decline in HRT use. Women were studied from 40 centers nationwide and randomly selected to either take a daily dose of HRT or a placebo, wrote WebMD.

Looking at the fatalities linked to lung cancer from the group who took HRT, there were statistically significant outcomes, said WebMD. Seventy-three women who had taken HRT died from lung cancer versus 40 women taking a placebo; many of the deaths were due to nonsmall cell lung cancer, according to WebMD.

"These results, along with the findings showing no protection against coronary heart disease, seriously question whether hormone-replacement therapy has any role in medicine today," wrote Apar Kishor Ganti, MD, of the University of Nebraska Medical Center in Omaha, in an accompanying commentary to the study, quoted WebMD. "It is difficult to presume that the benefits of routine use of such therapy for menopausal symptoms outweigh the increased risks of mortality, especially in the absence of improvement in the quality of life."


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