Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Anderson and colleagues,1 for the Women's Health Initiative, reported that
continuous combined estrogen plus progestin therapy may increase the risk
of ovarian cancer while producing endometrial cancer rates similar to placebo.
However, this conclusion does not reflect their findings. The prematurely
terminated estrogen plus progestin arm had an observed annual incidence rate
of 34 ovarian cancer cases per 100 000 person-years, somewhat less than
the anticipated population-based rate of 45 per 100 000 person-years.
The ovarian cancer rate in the estrogen plus progestin group "was elevated
(20 vs 12; HR, 1.58; 95% CI, 0.77-3.24 [adjusted 95% CI, 0.59-4.23]), but
not statistically significant." Nor did the Kaplan-Meier estimates of cumulative
hazards reach statistical significance.
Utian WH. Hormone Therapy and Risk of Gynecologic Cancers. JAMA. 2004;291(1):42. doi:10.1001/jama.291.1.42-b