Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: The Women's Health Initiative
(WHI) investigators1 found that use of conjugated
equine estrogen (CEE) was associated with a decreased risk of breast cancer
among women with prior hysterectomy. However, the trial was discontinued early
and I do not feel that this early termination was justified, given that the
cumulative hazard ratio (HR) of 0.77 (95% confidence interval [CI], 0.59-1.01)
narrowly missed statistical significance. It would have been important to
study the effects of additional years of treatment, as knowledge of hormone-dependent
cancers remains incomplete.
Kuhl H. Effects of Estrogen-Only Treatment in Postmenopausal Women. JAMA. 2004;292(6):683. doi:10.1001/jama.292.6.683-a