Decline in Hormone Replacement Prescription and Fall in Breast Cancer Incidence An Epidemiological Discourse

作者：Stang A^*

来源：Deutsches Arzteblatt International, 2008, 105(16): 303-U18.

DOI：10.3238/arztebl.2008.0303

• breast cancer
• hormone replacement therapy
• epidemiology
• cancer registry
• mammography

Introduction: Between 2002 and 2003 the incidence of invasive breast cancer among women aged 50 to 69 years declined considerably in the US. This decline was accompanied by a substantial fall in prescription rates of estrogen-progestin (EG-HRT).
Methods: Selective literature search in PubMed from 01/2003 to 12/2007 using the key words "hormone replacement therapy," "incidence," and "breast cancer."
Results: The parallel decline in EG-HRT and breast cancer suggests a causal link. Up to now, alternative explanations for the decline of the incidence can either be refuted or revealed as implausible.
Discussion: Detailed incidence trend analyses in the coming years and a close monitoring of EG-HRT prescription rates in and beyond the US. promise important insights. If EG-HRTs are carcinogenic, the extent of this effect remains unclear. If cessation of EG-HRT therapy only delays the appearance of detectable breast cancer, a long-term increase in incidence would be expected in women of age 50 and older, even with low prescription rates. However, if cessation of EG-HRT also stops tumor growth, the anticipated incidence will be permanently lower in the future.

• 出版日期2008-4-18
• 单位河北医科大学