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and rarer diseases such as ovarian cancer. They estimated that for healthy women in their fifties, use of HRT for five years would cause an extra breast cancer, stroke, or pulmonary embolism in 6 in every 1000 users, but reduce the incidence of colorectal cancer and hip fracture by 1.7 in every 1000--giving on balance an overall increase in one of these conditions of 4.3 out of every 1000 HRT users (1 in 250). For women in their sixties, the overall increase is 6.5 in every 1000 HRT users (1 in 150). Breast cancer was the most prominent negative health outcome among users in their fifties, which shifted to cardiovascular disease among women in their sixties.

Valerie Beral comments: "These estimates provide a rough guide to the likely overall change in the incidence of these conditions over a 5 year period for typical healthy HRT users in western countries. Each woman would, understandably, give different weight to the importance of each condition, as well as to the relief of menopausal symptoms."

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Contact: Richard Lane
richard.lane@lancet.com
44-207-424-4949
Lancet
19-Sep-2002

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