Endometrial cancer
- 30 Nov 2023
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Endometrial cancer
- Updated on 30 Nov 2023
- 1 Minute to read
- Print
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In women with an intact uterus, unopposed systemic oestrogen therapy increases the risk of endometrial cancer and is not recommenced. This risk is largely avoided through a systemic progestogen.
NICE says that evidence shows a reduced risk of endometrial cancer in:
- Current users of continuous combined HRT, with any duration of use.
- Current users of all combined HRT with less than 5 years of use.
- Long-term use of sequential combined regimes for >5 years may be associated with a small increase in risk of endometrial cancer.
- Use of low dose vaginal oestrogen treatments does not increase the risk of endometrial cancer.
NOTE:
- Continuous combined HRT, where the progestogen is taken every day with oestrogen, decreases the risk of endometrial cancer.
References and Further Information:
- National Institute for Health and Care Excellence. Guideline. Menopause (update). Draft for consultation, Nov 2023.
- Hamoda H, Panay N, Pedder H et al. The British Menopause Society & Women’s Health Concern 2020 recommendations on hormone replacement therapy in menopausal women. Found on page 190. Post Reprod Health 2020.
- Hamoda H. Progestogens and endometrial protection. British Menopause Society. Tools for clinicians. 2021.
- Crandall C, Hovey K, Andrews C et al. Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women's Health Initiative Observational Study. Menopause. 2018.
- Anderson G, Judd H, Kaunitz A et al. Effects of estrogen plus progestin on gynecologic cancers and associated diagnostic procedures: the Women’s Health Initiative randomized trial. JAMA 2003.
- Chlebowski R, Anderson G, Sarto G et al. Continuous Combined Estrogen Plus Progestin and Endometrial Cancer: The Women’s Health Initiative Randomized Trial. J. Natl. Cancer Inst. 2016
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