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Breast cancer incidence and hormone therapy in Canada

22 Feb 2011

Both women and healthcare professionals continue to be concerned about the risk of breast cancer with the use of Hormone Replacement Therapy and any new report looking at the association understandably attracts interest. Following publication of the Women’s Health Initiative trial in 2002, the use of HRT worldwide dropped significantly and some reports have suggested a parallel drop in the incidence of breast cancer.

A Canadian group has recently reported on a study evaluating use of hormone therapy and breast cancer incidence in Canadian women between 2001 and 2006. The data showed that HRT use of all types declined from 2001 to 2006 (from 11.6 million to 8.5 million prescriptions), with the largest reduction occurring from 2002 to 2003. The report showed that breast cancer incidence in Canadian women over the age of 40 reached a peak in 2002, declined from 2002 to 2004, but then rose again from 2004 to 2006. A similar fall and then rise was also shown in the women aged 50 to 69 years.

Many factors such as smoking, alcohol intake and mammography rates are relevant to breast cancer incidence. These data which show a rise in breast cancer incidence from 2004 to 2006, despite a continued decline in use of HRT, suggest that use of HRT may promote the growth of pre-existing breast tumour, rather than cause the cancer.

These findings agree with previously expressed views and although it is known that using certain types of HRT for a long time is associated with a small increased risk of breast cancer, it seems very unlikely that the cancer is initially caused by HRT, and both women and healthcare professionals should continue to balance risks against benefits when considering use and duration of Hormone Therapy.

[Reference]

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