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Ovarian Ca link hits confidence in HRT

GPs are bracing themselves for a new wave of women wanting to come off hormone replacement therapy after a major study confirmed the suspected link with ovarian cancer.

Women currently using HRT were 20 per cent more likely to develop ovarian cancer than non-users, the controversial Million Women Study reported in The Lancet last week.Current use of HRT also raised the risk of dying of ovarian cancer by 23 per cent, with the researchers estimating the treatment was responsible for 1,000 extra deaths from the disease since 1991.When the same study reported that HRT raised the risk of breast cancer in 2003, the number of women using it plummeted from two million to one million almost overnight, but the researchers insisted the latest findings would not necessarily change practice.Study leader Professor Valerie Beral, director of the Cancer Research UK epidemiology unit at the University of Oxford, said: 'Current regulations say if they take HRT they should take it for as short a time as possible, at as low a dose as possible, and consult their doctor regularly. The findings support that. 'GPs have to discuss with the woman how they view symptoms of menopause compared with the risk of breast and ovarian cancer. It's up to the GPs and women – it's a very important dialogue.'Some experts warned the findings – and the way they had been presented – could cause women to stop taking HRT unnecessarily.Dr Sarah Gray, a GP in Cornwall and member of the national council of the British Meno-pause Society, said: 'There will be people who are affected by the sensationalism of the message. It may unnecessarily make women stop taking HRT.'Women with an early meno-pause may gain considerable benefits and may consider stopping taking it where it would be completely inappropriate.'Dr Kevin Woodbridge, a GP in Orkney, said he had already been advising women of the link with ovarian cancer.'It's about weighing up the pros and cons. 'If women can't survive without it, they should use it for a short amount of time and review every month.'The Million Women Study followed up 948,576 postmenopausal women in the UK for an average of 5.3 years.

egoodman@cmpmedica.com

Million Women Study key findings

• Current users of HRT at 20 per cent increased risk of developing ovarian cancer• Current use also raised risk of dying of ovarian cancer by 23 per cent• Ovarian cancer risk rose with increasing years of HRT use• Past users of HRT were not at increased risk• Risk did not vary by HRT preparation

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