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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

HRT and ovarian cancer scare

The Lancet has published an analysis of the Million Women Study that has examined the risks of ovarian cancer in current and past hormone replacement therapy (HRT) users. This analysis has also been reported by the BBC and is likely to receive more media attention in the coming days.

The analysis has found a statistically significant increase in the risk of developing ovarian cancer. In real terms the additional risk is small equating to 1 additional diagnosis of ovarian cancer for every 2,500 users of HRT over a 5-year period and to 1 additional death for every 3,300 users over the same period.

The risk was found to increase with time with continuous use of HRT irrespective of the product type used. The excess risk was not found in past users.

The Medicines and Healthcare products Regulatory Agency has issued an alert about this study. They highlight that this finding is not new and the risks are already well documented. Current advice is that HRT should be used for at the minimum effective dose for the shortest duration for the short-term relief of menopausal symptoms.

Action: Clinicians should be aware of this new study because patients are likely to present with concerns in the coming days. Use of HRT in line with the current advice is safe and efficacious. This current scare can be used as an opportunity to persuade some long-term users of HRT, who have previously been resistant, to stop treatment.

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