Postmenopauzale hormonale suppletietherapie en kanker van de vrouwelijke geslachtsorganen en de mamma

– Oestrogen replacement therapy (ORT) significantly increases the relative risk (RR) of endometrial cancer, especially long-term oestrogen use (RR: 9.5; 95 confidence interval (CI): 7.4-12.3). Addition of a progestin to ORT reduces this increased risk completely or largely.

– The risk of breast cancer is increased after ORT of 5 years or longer (RR: 1.23; 95 CI: 1.08-1.40). Addition of a progestin does not reduce this increased risk.

– The possibility cannot be excluded that long-term ORT increases the risk of epithelial ovarian cancer.

– No significant association between ORT and cervical cancer has been demonstrated.

– It is safe to prescribe ORT for a period shorter than 5 years for women with menopausal symptoms. Addition of a progestin is indicated when the uterus is in situ.

– Hormonal suppletion therapy is to be discouraged in women treated for breast cancer, may be considered in young women previously treated for endometrial or ovarian cancer with a good prognosis and severe menopausal symptoms and is justified in women previously treated for cervical cancer.