The Controversy over Hormone Replacement Therapy: Evaluating Related Risk of Breast Cancer and Other Diseases PDF Download

Author:
Publisher: Am Cncl on Science, Health
ISBN:
Category :
Languages : en
Pages : 18

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Author: U. S. Department of Health and Human Services
Publisher: CreateSpace
ISBN: 9781490565552
Category : Medical
Languages : en
Pages : 132

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Book Description
In this systematic evidence review, we evaluate data on the relationship between the use of postmenopausal hormone replacement therapy (HRT) and the risk of breast cancer (BCA). The context of this review is in the overall evaluation of postmenopausal hormone replacement therapy as chemoprophylaxis for chronic conditions. The results from this report will be used as part of an overall report on the risks and benefits of hormone replacement therapy for postmenopausal women. Hormone replacement therapy is used in the United States and worldwide to treat symptoms of menopause and to prevent chronic conditions such as osteoporosis. It is one of the most commonly prescribed drugs in the U.S.; a recent survey in the U.S. of postmenopausal women ages 50 to 75 showed that nearly 38% of women were currently using estrogen or hormone replacement therapy (58.7% of those with prior hysterectomy and 19.6% without hysterectomy). A major and as yet unanswered clinical question is whether hormone replacement therapy increases a woman's risk of breast cancer. This issue is a critical one because the use of HRT is prevalent and because breast cancer is a relatively common disease, so that even a small increase in breast cancer in association with hormone use could significantly influence public health. The importance of endogenous estrogen in the development of breast cancer has been evaluated and confirmed in multiple studies of differing methodologies. Studies in animals have shown that breast cancer can be induced by the administration of estrogen. Among humans, some studies have shown that women with increased levels of circulating estrogen are at higher risk for the subsequent development of breast cancer. Other studies have had conflicting findings, and some have shown this relationship in postmenopausal women only. Reproductive events are important risk factors for breast cancer. Those shown to increase risk include early menarche and late menopause, both of which prolong exposure to higher levels of estrogen as well as other reproductive hormones. Other reproductive experiences, such as late age at first pregnancy and nulliparity, increase breast cancer risk. Oopherectomy among premenopausal women is protective against breast cancer, possibly because of reduced exposure to estrogen. Other risk factors also suggest an important role for estrogen in BCA development. In postmenopausal women, obesity, which correlates with increased estrogen levels, is also associated with an increased risk of BCA. Recent studies have also shown that increased bone density, possibly a reflection of lifetime estrogen exposure, is associated with increased rates of breast cancer. Finally, age-adjusted rates of increase in breast cancer incidence slow at menopause when estrogen levels fall. There are several critical key questions to consider when evaluating the research describing the role of exogenous estrogen or estrogen/progesterone in breast cancer development and prognosis. First, is either estrogen alone or estrogen with progesterone associated with a change in breast cancer mortality? Second, does short-term estrogen use increase the risk of breast cancer? The third question, which is most relevant to the use of estrogen to prevent chronic conditions, is whether long-term estrogen increases breast cancer risk. The fourth question, which reflects the current standard of practice, is whether the combination of estrogen and progesterone, either short-term or long-term, increases the risk of breast cancer. Fifth, is current use of estrogen or hormone replacement therapy associated with increased risk of breast cancer? Sixth, are there subpopulations of women who might be at increased risk of breast cancer when using HRT? Finally, because increased breast mammographic density is independently associated with an increase in breast cancer risk, as well as with decreased accuracy of mammography, does estrogen or estrogen/progestins change breast density?

Author:
Publisher: Am Cncl on Science, Health
ISBN:
Category :
Languages : en
Pages : 18

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Author: Hilary O. D. Critchley
Publisher:
ISBN: 9781904752110
Category : Menopause
Languages : en
Pages : 364

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Author: A.R. Genazzani
Publisher: CRC Press
ISBN: 9781842140383
Category : Medical
Languages : en
Pages : 208

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This is a high-level, clinical reference by world-class specialists on the efficacy of hormone replacement therapy for the primary prevention of cardiovascular risk in postmenopausal women. Specific chapters cover pulsed estrogen therapy with Aerodiol and cardiovascular risk assessment in postmenopausal hormone replacement therapies such as Livial (tibolone). This volume is based on the formal presentations and subsequent discussions that took place at the International Menopause Society specially convened Expert Workshop on Hormone Replacement Therapy and Cardiovascular Disease, London, UK, October 13-16, 2000.

Author: IARC Working Group on the Evaluation of Carcinogenic Risks to Humans
Publisher: World Health Organization
ISBN: 9283212916
Category : Medical
Languages : en
Pages : 544

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Oral contraceptives for family planning worldwide have revolutionized the reproductive lives of millions of women since their introduction in the 1960s. Later on, a variety of side-effects including cardiovascular diseases was recognized. In response to these concerns, new generations of combined oral contraceptives were developed that featured lower dose of estrogen and newer, more potent progestogens. The effectiveness and ease of use of combined hormonal contraceptives suggest that they will continue to be used to a significant extent in the future. This ninety-first volume of IARC Monograp.

Author: National Research Council
Publisher: National Academies Press
ISBN: 0309157331
Category : Social Science
Languages : en
Pages : 428

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In 1950 men and women in the United States had a combined life expectancy of 68.9 years, the 12th highest life expectancy at birth in the world. Today, life expectancy is up to 79.2 years, yet the country is now 28th on the list, behind the United Kingdom, Korea, Canada, and France, among others. The United States does have higher rates of infant mortality and violent deaths than in other developed countries, but these factors do not fully account for the country's relatively poor ranking in life expectancy. International Differences in Mortality at Older Ages: Dimensions and Sources examines patterns in international differences in life expectancy above age 50 and assesses the evidence and arguments that have been advanced to explain the poor position of the United States relative to other countries. The papers in this deeply researched volume identify gaps in measurement, data, theory, and research design and pinpoint areas for future high-priority research in this area. In addition to examining the differences in mortality around the world, the papers in International Differences in Mortality at Older Ages look at health factors and life-style choices commonly believed to contribute to the observed international differences in life expectancy. They also identify strategic opportunities for health-related interventions. This book offers a wide variety of disciplinary and scholarly perspectives to the study of mortality, and it offers in-depth analyses that can serve health professionals, policy makers, statisticians, and researchers.

Author: IARC Working Group on the Evaluation of Carcinogenic Risks to Humans
Publisher: World Health Organization
ISBN:
Category : Medical
Languages : en
Pages : 692

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Evaluates evidence for an increased risk of cancer in women using combined oral contraceptives, progestogen-only hormonal contraceptives, post-menopausal estrogen therapy, and post-menopausal estrogen-progestogen therapy. Although the carcinogenicity of these preparations has been extensively investigated, the book stresses the many complex methodological issues that must be considered when interpreting findings and weighing results. Evidence of an association between use of these preparations and positive effects on health, including a reduced risk of some cancers, is also critically assessed. The first and most extensive monograph evaluates evidence of an association between the use of combined oral contraceptives and cancer at nine sites. Concerning breast cancer, the evaluation concludes that, even if the association is causal, the excess risk for breast cancer associated with patterns of use that are typical today is very small. Studies of predominantly high-dose preparations found an increased risk of hepatocellular carcinoma in the absence of hepatitis viruses. Citing these findings, the evaluation concludes that there is sufficient evidence in humans for the carcinogenicity of combined oral contraceptives. The evaluation also found sufficient evidence for the carcinogenicity of some, but not all, combined preparations in animals. Combined oral contraceptives were classified as carcinogenic to humans. The evaluation also cites conclusive evidence that these agents have a protective effect against cancers of the ovary and endometrium. Progestogen-only contraceptives are evaluated in the second monograph, which considers the association with cancer at six sites. The evaluation found no evidence of an increased risk for breast cancer. Although the evaluation found sufficient evidence in animals for the carcinogenicity of medroxyprogesterone acetate, evidence for the carcinogenicity of progestogen-only contraceptives in humans was judged inadequate. Progestogen-only contraceptives were classified as possibly carcinogenic to humans. The third monograph, on post-menopausal estrogen therapy, considers evidence of an association with cancer at eight sites. Findings from a large number of epidemiological studies indicate a small increase in the risk of breast cancer in women who have used these preparations for five years or more. Studies consistently show an association between use of post-menopausal estrogen therapy and an increased risk for endometrial cancer. Data on the association with other cancers were either inconclusive or suggested no effect on risk. The evaluation concludes that post-menopausal estrogen therapy is carcinogenic to humans. The final monograph evaluates the association between the use of post-menopausal estrogen-progestogen therapy and cancer at four sites. The evaluation of limited data on breast cancer found an increased relative risk observed with long-term use. Data were judged insufficient to assess the effects of past use and of different progestogen compounds, doses, and treatment schedules. For endometrial cancer, the evaluation found an increase in risk relative to non-users when the progestogen was added to the cycle for 10 days or fewer. Post-menopausal estrogen-progestogen therapy was classified as possibly carcinogenic to humans. Concerning post-menopausal therapy in general, the book notes that evidence of carcinogenic risks must be placed in perspective of potential benefits. The prevention of osteoporotic fractures is cited as the best-established benefit. Evidence also suggests that estrogen prevents heart disease and may prevent memory loss and dementia.

Author: Antonio Cano
Publisher: Springer
ISBN: 3319593188
Category : Medical
Languages : en
Pages : 342

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This book provides an evidence-based approach to the universal experience of menopause. Its structured format clearly separates the biological basis from the clinical impact and quality of life, while also examining menopause within the context of healthy ageing in females. Accordingly, the book addresses factors including lifestyle, frailty, sarcopenia, and new ICT technologies. Written by respected experts in the field, the book offers a valuable guide for gynecologists and professionals devoted to women’s healthcare and ageing quality of life, while also sharing revealing insights for non-professionals.

Author: Edward Friedman
Publisher: Prometheus Books
ISBN: 1616147245
Category : Health & Fitness
Languages : en
Pages : 406

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Written by the leading authority on hormone receptors and prostate cancer, this book reveals the surprising truth about how you can prevent and treat breast cancer, prostate cancer, and Alzheimer's with testosterone and other FDA-approved drugs. For decades, doctors have sought to combat prostate cancer under the mistaken assumption that testosterone fueled its growth. But the latest research into the nature of hormone receptors and therapies using bioidentical instead of synthetic hormones have caused a shift in thinking and new hope for treating this cancer with testosterone. Today the medical profession equates a diagnosis of Alzheimer's with a death sentence. In fact, the only thing doctors do is throw ineffective drugs at it and resign themselves to failure. For the first time, this book explains how testosterone can halt the disease and cure early-stage Alzheimer's. Similar breakthroughs for fighting breast cancer follow close on the heels of these revelations, outlining how the avoidance of synthetic progestins and the use of aromatase inhibitors are crucial tools in prevention and treatment. At the core of this book is the remarkable observation that we experience our highest hormone levels during our teen years--a time of life when there is no breast cancer, prostate cancer, or Alzheimer's. Could bringing hormones back to teen levels be the key to vibrant good health? The answer is a resounding yes. This thoroughly researched guide to the latest biomedical research is must-reading for medical professionals and anyone concerned about their health.