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Study finds fewer, but more advanced, colon cancers in postmenopausal women on E&P hormone therapy

BUFFALO, N.Y. -- "Get a routine colonoscopy whether or not you are taking hormone therapy after menopause."

That is the primary message women should take away from the latest study from the Women's Health Initiative (WHI) on the relationship of estrogen and progestin replacement and colon cancer, said study co-author Jean Wactawski-Wende, Ph.D., from the University at Buffalo.

Results of the study, which appeared in the March 4 issue of The New England Journal of Medicine, showed that while there were fewer colon cancers among women in the treatment group than among women taking a placebo, colon cancers that did develop in the treatment group were more advanced when diagnosed, suggesting a poorer outcome.

Wactawski-Wende, second author on the study, co-directs UB's WHI Vanguard Center and is an assistant professor of social and preventive medicine and gynecology and obstetrics. "The results of the current study that show more advanced cancers in the treatment group are somewhat puzzling," said Wactawski-Wende. "We think it's possible that women receiving estrogen and progestin may have attributed colon cancer symptoms, such as constipation, diarrhea, cramping or stomach pain, to the hormone treatment, and delayed cancer screening. Or they may have been distracted from reporting potential symptoms of colon cancer by symptoms related to their HRT therapy, such as vaginal bleeding.

"It's also possible that the hormone treatment only prevents pre-cancerous lesions from progressing," she said. "Study participants weren't screened for colon cancer when they entered the study, and colon screening wasn't part of the WHI activities, so we don't know if those who were diagnosed with colon cancer during the study already had cancerous polyps."

The current study updates findings from the WHI on colorectal cancer reported in 2002, when the estrogen plus progestin replacement trial was halted. The study was stopped because, contrary to expect
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Contact: Lois Baker
ljbaker@buffalo.edu
716-645-5000 x1417
University at Buffalo
16-Mar-2004


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