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Hormone replacement therapy (HRT) is associated with an increased risk of ovarian cancer in postmenopausal women, according to a large cohort study from the United Kingdom. The risk is small but potentially important and adds up to one extra ovarian cancer for every 2500 women taking HRT for five years. The authors estimate that HRT has been linked to 1300 additional ovarian cancers and 1000 additional deaths in the UK since 19911991.
The study tracked more than 900000 postmenopausal women for an average of seven years. More than 2000 women developed ovarian cancer and 1591 died of it during that time. The relative risk of cancer among current users of any HRT was 1.20 (95% CI 1.09 to 1.32), and the relative risk of death was 1.23 (1.09 to 1.38). The increased risk was confined to women who took HRT for five years or more. Past users were unaffected.
The extra cancers were not due to differences between women who do and do not use HRT, as the authors adjusted their analyses for a dozen potential confounding factors including age, wealth, parity, history of hysterectomy, smoking, body mass index, and time since the menopause.
It's still unclear how or why these hormonal products cause ovarian cancer in older women (if they do). Similar products are protective in premenopausal women.