“Ovarian cancer is a rare condition but all the risks and benefits of hormone therapy need to be carefully considered when treating women at menopause”.1

Umbrella
What may the Hormone Therapy and Ovarian Cancer Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Cancer of the Ovary
  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Menopausal Hormone Replacement Therapy (MHT)
  • Ovarian Cancer

Ovarian Cancer Risk

What was the Collaborative Group on Epidemiological Studies of Ovarian Cancer’s Interpretation in their Meta-Analysis?

In Menopausal Hormone Use and Ovarian Cancer Risk: Individual Participant Meta-Analysis of 52 Epidemiological Studies (Meta-Analysis) published in February 2015, the Collaborative Group on Epidemiological Studies of Ovarian Cancer’s Interpretation was:

Hormone Therapy and Ovarian Cancer
“The increased risk may well be largely or wholly causal; if it is, women who use hormone therapy for 5 years from around age 50 years have about one extra ovarian cancer per 1000 users and, if its prognosis is typical, about one extra ovarian cancer death per 1700 users”.2

International Menopause Society

What did the International Menopause Society (IMS) note about the Meta-Analysis and hormone replacement therapy (HRT)?

The Statement from Dr Rodney Baber, President IMS Re the Recent Report on Ovarian Cancer Risk Associated With HRT Usage Published In The Lancet, 13th February 2015 note:

“My advice to women using HRT would be that this study at worst suggests a very small increase in risk with use of HRT, that this is no reason for them to stop taking their HRT, that the benefits of HRT in their own individual case should be weighted up against this information and that they should discuss this with their own doctor”.3

RCOG/British Menopause Society

What did the (British) Royal College of Obstetricians and Gynaecologists (RCOG) and the British Menopause Society (BMS) note about the Meta-Analysis?

In Joint RCOG/BMS Statement Lancet Study Examines Use of HRT and Ovarian Cancer Risk the RCOG ((British) Royal College of Obstetricians and Gynaecologists) Vice President of Education’s quoted comments note:

““This study does not provide evidence that HRT is the cause of ovarian cancer. Millions of women are currently taking or are considering HRT, to treat significant menopausal symptoms that cause serious distress to their quality of life, will be confused or anxious by this information. HRT, like any medication or treatment, has risks and benefits. The very small risk that this study highlights must be put in context – in that for 1,000 women who use HRT for 5 years from around the age of 50, there will only be one extra case of ovarian cancer””.4

Australasian Menopause Society

What did the Australasian Menopause Society (AMS) note about the Meta-Analysis?

In Short-Term Use of Hormone Replacement Therapy (HRT) and Ovarian Cancer Risk: Comment From AMS the AMS President’s comments note:

“In the days since the study was released examination of the relative and absolute risk calculations have shown them to be incorrect. The revised absolute risk increase appears to now sit at just under 1 extra case per 10,000 women per year; somewhat less than the study initially suggested. Ovarian cancer is a rare condition but all the risks and benefits of hormone therapy need to be carefully considered when treating women at menopause. Women should not stop hormone therapy based on this study but if they are concerned they should discuss the findings with their doctor”.5

More Information

Where may I find more information about this Meta-Analysis?

You may find more information about this Meta-Analysis in the NHS’s (National Health Service, England) HRT Ups Ovarian Cancer Risk 43% But Overall Risk Still Small.

Health Care Provider

If I choose to use hormone therapy (HT) what is my risk of ovarian cancer?

Different women who choose to use HT can have different risks of ovarian cancer. It may therefore be in your best interest to also choose to ask your health care provider about this.

On page one in Deciding About Hormone Therapy Use the NAMS explain:

“Every woman is different—and you must make a decision about whether to use HT based on the severity of your symptoms, your personal and family health history, and your own beliefs about menopause treatments. Your healthcare provider will be able to help you with your decision”.6

One of the points of consensus about menopausal hormone therapy (MHT) in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016, is:

  • “The option of MHT is an individual decision in terms of quality of life and health priorities as well as personal risk factors such as age, time since menopause and the risk of VTE, stroke, ischemic heart disease and breast cancer. MHT should not be recommended without a clear indication for its use”.7

What is VTE?

VTE can be an abbreviation for Venous Thromboembolism.

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Sources

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Sources

  1. Short-Term Use of Hormone Replacement Therapy (HRT) and Ovarian Cancer Risk: Comment From AMS. Content Updated: 17 February 2015. Australasian Menopause Society https://www.menopause.org.au/hp/news/729-short-term-use-of-hrt-and-ovarian-cancer-risk Accessed: 22 July 2020
  2. Collaborative Group on Epidemiological Studies of Ovarian Cancer. Menopausal Hormone Use and Ovarian Cancer Risk: Individual Participant Meta-Analysis of 52 Epidemiological Studies – Summary: Interpretation. Lancet Volume 385, ISSUE 9980, P1835-1842, May 09, 2015 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61687-1/fulltext#%20 Accessed: 22 July 2020
  3. Statement From Dr Rodney Baber, President IMS Re the Recent Report on Ovarian Cancer Risk Associated With HRT Usage Published In The Lancet, 13th February 2015. 2015:2. International Menopause Society https://www.imsociety.org/downloads/news/statement_on_lancet_paper_2015_02_13_rod_baber_ims_president.pdf Accessed: 22 July 2020
  4. Joint RCOG/BMS Statement: Lancet Study Examines Use of HRT and Ovarian Cancer Risk. Royal College of Obstetricians and Gynaecologists https://www.imsociety.org/downloads/news/statement_on_lancet_paper_2015_02_13_bms_rcog.pdf Accessed: 22 July 2020
  5. Short-Term Use of Hormone Replacement Therapy (HRT) and Ovarian Cancer Risk: Comment From AMS. Content Updated: 17 February 2015. Australasian Menopause Society https://www.menopause.org.au/hp/news/729-short-term-use-of-hrt-and-ovarian-cancer-risk Accessed: 22 July 2020
  6. Deciding About Hormone Therapy Use. 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 22 July 2020
  7. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Pierroz. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT. Climacteric, 2016;19:4:314 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 22 July 2020
Topic Last Updated: 22 July 2020 – Topic Last Reviewed: 22 July 2020
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