This news story from the Telegraph yet again speaks of the link between breast cancer and HRT. Yet again, this news is bound to cause more confusion on the issue for our readers who are no doubt concerned about their health, about hormone replacement and whether there is a connection between HRT and breast cancer. When your first read this article, keep in mind that the exact cause of breast cancer is still unknown, though age, relatives with breast cancer, alcohol consumption and diet are still believed to influence who gets breast cancer. Also interesting to note is the fact that mainstream media still does not talk about natural bio-identical hormones. It’s interesting because it gives one the impression that the mainstream media when speaking about hormones has either been forbidden to speak about natural bio-identical hormones or else they just don’t know about this advance in medicine.
“The Million Women Study suggested that women taking HRT were twice as likely to develop breast cancer and more likely to die from it than those not taking the therapy.
The study, funded by Cancer Research UK and conducted by a team at Oxford University, triggered a collapse in confidence in Hormone Replacement Therapy and the number of women taking it halved.
Several studies subsequently showed a small increased risk of cancer and a fierce debate has raged over the issue.
In 2002, before the Million Women Study reported there were 4.9m prescriptions dispensed in England for the treatment, compared with 2.3m last year.
A new analysis of the study and two others, found it cannot prove that the treatment causes an increased risk of developing breast cancer, experts said.
There were many flaws in the study including that women may have already had breast cancer when they were enrolled in the study and that they were at increased risk of dying within three years which was ‘biologically implausible’, the researchers said.
Writing in the Journal of Family Planning and Reproductive Health Care Prof Samuel Shapiro from the University of Cape Town and others said: “The name ‘Million Women Study’ implies an authority beyond criticism or refutation.
“Here we conclude that the evidence in the Million Women Study was indeed unreliable. There were defects in the study design, and the findings did not adequately satisfy the principles of causation.
“HRT may or may not increase the risk of breast cancer but the Million Women Study did not establish that it does.”
The authors said inviting women to join the study would in itself have increased the number already aware of breast lumps or precancerous changes, leading to higher numbers of cancers being detected (detection bias), they added.
This is borne out by a higher rate of cancers among the study participants than in the general population, irrespective of whether or not they used HRT.
The authors also argued that crucial data was often also missing.
Prof Shapiro wrote: “Yet the validity of any study is dependent on the quality of its design, execution, analysis and interpretation. Size alone does not guarantee that the findings are reliable.
“The Million Women Study was an observational study, and it has the attendant problems and uncertainties intrinsic to such studies.
“If the evidence was unreliable, the only effect of its massive size would have been to confer spurious statistical authority to doubtful findings.”
Prof Shapiro and the other authors declared ‘competing interests’ in the research paper, in that they had all acted as consultants for pharmaceutical companies that make HRT, currently or in the past.
Dr Susie Jennings, Senior Policy Officer at Breakthrough Breast Cancer, says: “Many studies have shown that HRT increases the risk of breast cancer and this study does not change that. It does suggest the risks may, in some instances, have been slightly overstated.
“However, we know that the risk of breast cancer starts to decrease as soon as a woman stops taking HRT.
“We hope the Breakthrough Generations Study, which is following 110,000 UK women over 40 years, will provide further clarity on this issue.”
Hazel Nunn, head of health information at Cancer Research UK, said: “Women shouldn’t be unduly worried by this latest review of HRT and breast cancer risk. HRT can be an effective short-term treatment for menopausal symptoms – women taking it should try and use the lowest dose possible for as short a time as they need it.
“If you are considering starting or stopping HRT, or using it for a long time, you should discuss it with your doctor. The issues are different for every woman and your doctor will be able to help you weigh up the benefits and risks of different types of HRT and make the right choice based on your own circumstances.
“In the UK, HRT use has been falling since the start of the Millennium. Studies suggest that in 2005 there were 1,400 fewer cases of breast cancer in the UK among women aged 50-59 than would have been if there had been no drop in HRT use.”
The co-authors of the Million Women Study refuted the claims. “
This story originally appeared in the Daily Telegraph.
