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[Jari]

 

[bear]

Yay Jari 

And to all ladies who have posted that this study does not take alcohol into account:

'To ensure women in one study were compared directly only with similar women in the same study, analyses were routinely stratified by study, centre or region within study, age (<40, single years of age from 40 to 69, 70-74, 75-79 and 80-89), body mass index (BMI <25, 25-29, 30+ kg/m2; ‘lean‘ = <25 and ‘obese' = 30+ kg/m2); adjusted for family history (first degree relative with breast cancer, yes or no), alcohol consumption (0, <10, 10+ g/week), and reproductive history (nulliparous, and, among parous women, by parity [1-2, 3+] and age at first birth [<20, 20-29, 30+ years]). They also allowed for age at menopause, but in a different way (see below), as this important information was not always available. For all stratification or adjustment factors the data provided by the principal investigators were used, with definitions as similar as possible across studies.'

BeaR.

[CLKD]

So the risk of GPs not prescribing having read theses articles, against the risk of women getting breast disease? 

[bear]

So the risk of GPs not prescribing having read theses articles, against the risk of women getting breast disease?

Hi CLKD,

It's too soon for GP's to have an informed opinion based on this study, let's wait for scientists and medical doctors trained in Epidemiology and Statistics to scrutinise it, including NICE and BMS experts (I also don't like this word, but it seems to be everywhere now).

The risks of BC linked to HRT are well known and considered small, that hasn't prevented GP's from prescribing it. The absolute increases in risks verified in this study (still awaiting scrutiny) are also small when you consider individual cases, but it's significant for public health concerns.

I'm not sure I have answered your question, but that's my 2pworth. 

BeaR.

[CLKD]

The Study has obviously been 'out there' for a while because Louise had an article in Sat's telegraph  .  Which I found difficult to understand and may be a pat response to scare mongering articles ?  I need to re-read it.

Surely NICE should get to grips with any such startling information prior to the press getting their mucky hands on it?

[dahliagirl]

I thought research was presented to peers at conference etc for scrutiny before it was considered for policy.

The trouble with epidemiology and statistics is that it can find link, which this has done.  We know that there is a link with breast cancer and HRT.  But we do not know what that link is and hard science RCT are needed to find out what that link is and isolate the mechanisms, then something can be done.

We knew there was a link before, and this study shows that link exists (again) and that it may last longer than thought, but it still does not tell us what that link is.   There have been a number of studies since the millennium and million women trials looking at different progestogens to see if that could be a cause, and detailed analysis of the numbers has shown that it could be an effect, but we need a lot more of this sort of research before we get any answers.

I don't know why this study got so much attention.  They have only said there is a link and have not come up with anything that proves that HRT actually causes BC, and the study does not show that HRT increases the number of deaths from BC.

[Hurdity]

Great post dahliagirl

Hurdity x

[dahliagirl]

I hope so - my brain keeps going round in circles 

Epidemiology is great for public health issues and it is great as an overview, but you do need more.

[Jari]

I guess time will be the answer. As many more women take hrt now, they will start to see over the next decade, what will be the outcome. Hopefully by then they will have a clearer picture, but it's good they carry on with all this research in the meantime. 👍

[Bobidy]

If I had 3 wishes...

I wish they would just move on now and focus their efforts, time and money into researching the effects of newer hrt preparations and testosterone. Something we would find useful. Maybe this is going on in the background?

I wish the headline was highlighting the urgent need for primary healthcare training in Menopause / hrt prescribing, moving away from old preparations with the greatest associated risk, and away from mis-prescribing anti depressants / pain killers. Surely this is the bigger issue? That way women's bc risk can be better assessed, although it seems most times it is unknown anyway.

I finally wish we could start some kind of petition to get this stuff through parliament. I know Diane Danzebrink is doing a lot of great work in this area.

I can but hope x

[Jari]

Good idea Bobidy. I think you can start a petition?!  Go to the gov petition site. Can't remember how to get there, but if you google it, you can then start a petition.  I think it needs 10000 signatures (all online) to get debated in Parliament. X

[Jari]

Bobidy, just looked it up...

https://www.gov.uk/petition-government   X

[Butterfly22]

So true Bobidy, I'm not saying this is all that has come out but in the 20 years I've been taking hrt I've literally seen one new one added but a few discontinued. Some women really struggle finding a subtitle one, there needs to be more choice and certainly more help.
I think modern living, eating ect play havoc with us and it's worse then years ago plus ladies are living longer. X

[Jenna]

If I had 3 wishes...

I wish they would just move on now and focus their efforts, time and money into researching the effects of newer hrt preparations and testosterone. Something we would find useful. Maybe this is going on in the background?

I wish the headline was highlighting the urgent need for primary healthcare training in Menopause / hrt prescribing, moving away from old preparations with the greatest associated risk, and away from mis-prescribing anti depressants / pain killers. Surely this is the bigger issue? That way women's bc risk can be better assessed, although it seems most times it is unknown anyway.

I finally wish we could start some kind of petition to get this stuff through parliament. I know Diane Danzebrink is doing a lot of great work in this area.

I can but hope x

Just to refresh our memories, this is Diane's petition:

https://www.change.org/p/penny-mordaunt-mp-make-menopause-matter-in-healthcare-the-workplace-and-education-makemenopausematter

[Hurdity]

Thanks for re-posting that petition Jenna

I guess time will be the answer. As many more women take hrt now, they will start to see over the next decade, what will be the outcome. Hopefully by then they will have a clearer picture, but it's good they carry on with all this research in the meantime. 👍

The main issue though is that just collection of data through what they term "prospective studies" does not provide a clearer picture and it is randomised controlled trials ( as well as biological investigation) that need to be carried out. Unfortunately I doubt there will ever be trials on the same scale as the WHI study which is why it continues to be quoted, but there are smaller trials which are carried out and reported - though they are never given the same promonence it seems.

Hurdity x