News&Notes

HRT use and risk of ovarian cancer

Current use of HRT for prolonged periods is associated with a 20% increase in risk of ovarian cancer, according to data from the Million Women Study¹. Postmenopausal women (948 576) were followed for averages of 5.3 years for incident ovarian cancer and 6.9 years for death: 30% were current HRT users and 20% past users. Mean duration of use was 7.7 years.

There were 2273 ovarian cancers and 1591 deaths from the malignancy. Current users of HRT were significantly more likely to develop and die from ovarian cancer than never‐users. Risk increased with duration of use; however, past users were not at significantly increased risk. The crude incidence rate in the study population as a whole was 2.2 per 1000 women; in never‐users it was 2.2 per 1000, and in users 2.6 per 1000 (rates for death from ovarian cancer were 1.3, 1.3 and 1.6 per 1000, respectively). Assuming that the differences are caused by use of HRT, the authors calculate that, over a five‐year period, there would be about one extra case of ovarian cancer for every 2500 users (and one extra death per 3300 users).

1. Beral V, Million Women Study Collaborators. Ovarian cancer and hormone replacement therapy in the Million Women Study. The Lancet early online publication, 19 April 2007. DOI: 10.1016/ S0140‐6736(07)60534‐0 (also see comment: DOI: 10.1016/ S0140‐6736(07)60535‐2)

Alendronate prevents bone loss in men undergoing androgen deprivation therapy

Alendronate can reduce the loss in bone mass caused by androgen deprivation therapy (ADT), according to a recent randomised double‐ blind trial in 112 men (age≤85 years) taking ADT for non‐metastatic prostate cancer.¹ At baseline, 39% of men had osteoporosis and 52% had low bone mass. The median duration of ADT treatment was 14 months. Oral alendronate (70mg once weekly) or placebo was administered for one year; all patients received vitamin D and calcium supplementation. Patients underwent assessment of bone‐mineral density (BMD) of the spine and hip and of markers of bone resorption and formation at baseline and at one year. In the alendronate group, BMD increased significantly from baseline, by 3.7% (P<0.001) in the spine and by 1.6% (P=0.008) at the femoral neck. In the placebo group, losses of 1.4% and 0.7%, respectively, were recorded. Bone turnover significantly decreased from baseline in alendronate patients only

No between‐group differences in adverse events were observed. The study was not powered to evaluate differences in fracture rates.

The authors conclude that weekly alendronate significantly increased BMD and prevented the loss of bone mass associated with ADT treatment in men with prostate cancer.

1. Greenspan SL, Nelson JB, Trump DL, Resnick NM. Effect of once‐weekly oral alendronate on bone loss in men receiving androgen deprivation therapy for prostate cancer. Ann Intern Med 2007;146: 416‐24. Copyright © 2007 Wiley Interface Ltd