Stephen J.LurieMD, PhD, Senior Editor
To the Editor: It is premature for the authors of the WHI1 study to conclude that "the absolute numbers of excess [adverse] outcomes [due to HRT] would increase. . . . " given that the actual overall mortality for the HRT group was still lower than that for the placebo group (0.52% per year vs 0.53% per year, respectively). There are diseases other than breast cancer and effects of HRT that are not yet understood. For example, mortality due to colon cancer is greater than mortality due to breast cancer,2 and the 6-month mortality of hip fracture is greater than the 10-year mortality of stage 1 breast cancer3; therefore, the observed reductions in colon cancer and hip fracture may offset the increase in breast cancer. Until we know what happens to the women in the WHI trial over the next 5 years, we cannot estimate if they have been harmed or helped by HRT. The study is incomplete without further follow-up.
Goodson III WH. Risks of Postmenopausal Hormone Replacement. JAMA. 2002;288(22):2820. doi:10.1001/jama.288.22.2820-JLT1211-1-5