[Estrogen replacement therapy and breast cancer].
BACKGROUND
Sales of HRT in Norway have increased considerably over the last 10 to 15 years, as has the incidence of breast cancer. The aim of this study was to investigate the relationship between use of HRT and risk of breast cancer in a Norwegian cohort of women.


METHODS
The Norwegian Women and Cancer (NOWAC) study is a representative, national, population-based cohort study involving 31,451 postmenopausal women aged 45-64 who contributed information on reproduction, lifestyle and use of HRT. The women are followed up for breast cancer.


RESULTS
Current users of HRT, 35% of those included, had an adjusted relative risk of breast cancer of 2.1 (95% CI 1.5-2.5). A continuous regimen of estrogen/progestagen implied an increased risk compared to a sequential regimen. Longer use increased the risk (test for trend p<0.0001). The population-attributable risk of breast cancer due to use of HRT was estimated at 27%, which equals approximately 300 cases of breast cancer per year among Norwegian women aged 45-64.


CONCLUSIONS
Our results suggest that current use of HRT could be considered a major determinant of the increasing incidence of breast cancer in postmenopausal women in Norway. Treatment should, accordingly, be restricted to women with serious vasomotor complaints. The dosage should be individually tailored according to potential risks and benefits, and treatment given over a short period of time.
Bakken
Kjersti
K
Institutt for samfunnsmedisin, Universitetet i Tromsø, 9037 Tromsø. kjersti.bakken@ism.uit.no
Alsaker
Elin
E
Eggen
Anne Elise
AE
Lund
Eiliv
E
D001943:Breast Neoplasms / Q000139:chemically induced*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011372:Progestins / Q000009:adverse effects; D012307:Risk Factors; D011795:Surveys and Questionnaires
D011372:Progestins