Decrease in breast cancer incidence following a rapid fall in use of hormone replacement therapy in Australia.
OBJECTIVE
To determine if the recent rapid fall in use of hormone replacement therapy (HRT) in Australia has been followed by a reduction in breast cancer incidence among women aged 50 years or older, but not among younger women.


METHODS
Analysis of trends in annual prescribing of HRT, using Pharmaceutical Benefits Scheme data, and in annual age-standardised breast cancer incidence rates in Australian women for the period 1996-2003.


RESULTS
In Australia, prescribing of HRT increased from 1996 to 2001, but dropped by 40% from 2001 to 2003. Age-standardised breast cancer incidence rates in women aged > or = 50 years also increased to 2001 but declined thereafter. The incidence rates in this age group were lower by 6.7% (95% CI, 3.9%-9.3%; P < 0.001) in 2003 compared with 2001, equivalent to 600 (95% CI, 350-830) fewer breast cancers (out of about 9000 incident breast cancers annually for women this age). There was no significant change in breast cancer incidence for women aged < 50 years.


CONCLUSIONS
While other factors may have contributed to a recent reduction in breast cancer incidence among Australian women aged > or = 50 years, the available evidence suggests that much of the decrease is due to the recent fall in use of HRT. This is consistent with other evidence that the HRT-associated increase in risk of breast cancer is reversible after ceasing use of HRT.
Cancer Epidemiology Research Unit, The Cancer Council NSW, Sydney, NSW, Australia. karenc@nswcc.org.au
Karen
K
Canfell
Emily
E
Banks
Aye M
AM
Moa
Valerie
V
Beral
D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012307:Risk Factors