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Joint RCOG/BMS statement: Lancet study examines use of HRT and ovarian cancer risk

13 February 2015

A study published today (13 February 2015) in The Lancet, looks at short-term use of hormone replacement therapy (HRT) and the possible increased risk of ovarian cancer.

The findings from a meta-analysis of 52 epidemiological studies, involving a total of 21488 women with ovarian cancer, almost all from North America, Europe and Australia, suggest that taking HRT for the menopause, even for just a few years, is associated with an increased risk of developing the two most common types of ovarian cancer.

Commenting on the meta-analysis, Dr Clare McKenzie, RCOG Vice President or Education said:

“The RCOG welcomes the further information that this study provides. However, there are concerns about the effect that this isolated information will have on women.

“This study does not provide evidence that HRT is the cause of ovarian cancer. Millions of women are currently taking or are considering HRT, to treat significant menopausal symptoms that cause serious distress to their quality of life, will be confused or anxious by this information.

“HRT, like any medication or treatment, has risks and benefits. The very small risk that this study highlights must be put in context - in that for 1,000 women who use HRT for 5 years from around the age of 50, there will only be one extra case of ovarian cancer.

“Women should consider this factor in determining whether to continue to take HRT and balance it against the proven benefits in managing their individual symptoms. For the majority, this will mean that they will continue with treatment."

Dr Heather Currie, Chairman Elect for the British Menopause Society (BMS) and spokesperson for the RCOG said:

“While ovarian cancer is a serious disease, this study does not prove causation, particularly when it is stated that the incidence of ovarian cancer decreases with time after stopping HRT.

“Additionally, the data are observational with significant risk of bias from other contributing risk factors. It is important to emphasise that the absolute risk is extremely small.

“Women who are currently taking HRT should not be concerned by this report. HRT is the most effective treatment for symptoms of the menopause and when HRT is individually tailored, it provides more benefits than risks for the majority of women under the age of 60, and for many beyond that age.”

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