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GPs told to ignore latest HRT scare

The RCGP has told GPs to ignore new research on oestrogen-only hormone replacement therapy, which showed a 'possible' reduction in the risk of breast cancer, because it is irrelevant to UK practice.

Experts were concerned the new data would lead to another outbreak of hysteria surrounding the controversial treatment and advised GPs to make sure the patient was fully informed of the decision to take HRT.

The study, an analysis of the Women's Health Initiative, showed a possible risk reduction in women taking oestrogen-only HRT who were aged 50-79 and had a hysterectomy.

However, the researchers concluded the risk of harm from unopposed oestrogen indicated no overall benefit.

The study, which appeared in the Journal of the American Medical Association (April 14), also showed no effect on CHD incidence, a decreased risk of hip fracture, but an increased risk of stroke over seven years.

RCGP spokeswoman on women's health, Dr Sarah Jarvis, was concerned another outbreak of hysteria would further tarnish a therapy that had the potential to vastly improve quality of life.

Dr Jarvis, a GP in west London, said: 'This WHI data adds nothing to what we already know. I'm reasonably optimistic GPs will be adequately informed about HRT.'

She added women tended to link the relatively high risk of breast cancer in women in their 50s with the use of HRT.

Dr Jarvis advised GPs to make sure treatment decisions were fully informed and very individualised.

'We're moving towards being medicolegally very careful,' she added.

The Department of Health said it would be reviewing the study and would change its advice to GPs if necessary.

Latest advice from the Committee on Safety of Medicines states HRT is favourable for treating menopausal symptoms at 'the minimum effective dose' and 'for the shortest duration'.

HRT timeline: the major studies


July Women's Health Initiative study aborted due to significantly increased rates of breast cancer


May WHI analysis finds a 31 per cent rise in risk of stroke for women on oestrogen plus progestin HRT

August UK Million Women Study reveals that HRT could double breast cancer risk

CSM tries to assuage fears and urges GPs not to 'necessitate any urgent changes' to treatment

December Government position statement on HRT recommends 'the lowest effective dose should be used for the shortest duration' and that it should not be used first-line for prevention of osteoporosis


March Oestrogen-only arm of WHI stopped a year early due to increased rate of stroke

April Oestrogen-only data shows no overall benefit, but potential reduction in risk of breast cancer

By Rob Finch

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