HORMONE REPLACEMENT THERAPY AND CANCER
Abstract
Background. Sex steroids are not known to damage DNA directly. They can stimulate or inhibit cell proliferation, and thus can modulate tumor developmental progression.
Results. Sex steroids-related tumors in women are represented by breast cancer and endometrial cancer, and a possible relationship exists between sex steroids and both ovarian and colon cancer. Among current ERT users or those who stopped use 1–4 years previously, the relative risk of having breast cancer diagnosed is low, increases by factor of 1.023 for each year of hormone use. An appropriate combination of estrogen and progestin does not appear to increase, and may even decrease, the risk of endometrial cancer. Studies on HRT and risk of epithelial ovarian cancer have produced conflicting results but most data seem to exclude a strong assotiation. It is important that available data suggest a reduced risk of benign colorectal adenoma and colon cancer for 30–40%.
Conclusions. After breast cancer, endometrial cancer, melanoma or epithelial ovarian cancer HRT is not absolute contraindication. Low-grade endometrial stromal sarcoma should be considered to be a contraindication to HRT.
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