Estrogen replacement therapy after endometrial cancer: a survey of physicians' prescribing practice.
OBJECTIVE
To determine whether the prescribing practice of physicians with regard to estrogen replacement therapy (ERT) in symptomatic women with previous endometrial cancer is consistent with the available evidence.


METHODS
A descriptive survey was conducted among physicians in Germany, using a questionnaire containing two hypothetical cases of endometrial cancer patients ('low-risk' and 'high-risk' disease) and menopausal symptoms. Physicians were asked about their prescribing practice concerning moderate to severe menopausal symptoms.


RESULTS
Four hundred and twenty questionnaires were sent out, with an overall response rate of 39.8%; 45.6% in the 'low-risk' case and 75.4% in the 'high-risk' case (p < 0.0001) stated that ERT is contraindicated. Only 12.9% were willing to prescribe ERT; 81.9% preferred to prescribe non-estrogenic alternatives (44.8% phytoestrogens, 29.0% selective serotonin reuptake inhibitors).


CONCLUSIONS
Despite the evidence that ERT does not increase the risk of recurrence of endometrial cancer, many physicians are reluctant to prescribe ERT in women suffering from moderate to severe menopausal symptoms.
Hancke
K
K
Department of Obstetrics and Gynecology, University of Freiburg School of Medicine, Freiburg, Baden-Württemberg, Germany.
Foeldi
M
M
Zahradnik
H P
HP
Gitsch
G
G
Gilbert
L
L
Denschlag
D
D
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology; D001291:Attitude of Health Personnel; D000075202:Contraindications; D016889:Endometrial Neoplasms / Q000150:complications* / Q000473:pathology; D015914:Estrogen Replacement Therapy; D005260:Female; D005858:Germany; D019584:Hot Flashes / Q000188:drug therapy; D006801:Humans; D007989:Libido; D008593:Menopause; D048789:Phytoestrogens / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018570:Risk Assessment; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D011795:Surveys and Questionnaires
D048789:Phytoestrogens; D017367:Selective Serotonin Reuptake Inhibitors