The narrative review included studies where postmenopausal cancer survivors received menopausal hormone therapy (MHT) in melanoma, colorectal and lung cancers «Fiol G, Lete I, Nieto L, ym. Associations between ...»1.
Five observational studies on the use of MHT in women with colorectal cancer (CRC) included two prospective and three retrospective cohorts totaling 5510 women receiving some form of MHT. MHT preparations included oestrogens alone or combined with a progestogen, tibolone, or tissue selective oestrogen complex with any route of administration (oral, transdermal, vaginal, or intra-nasal). The impact of MHT was compared with placebo or non-treatment controls. Patients' age range was 45-79 years, mean follow-up time 6.5 years. The impact of MHT was compared with placebo or non-treatment controls.
There was a significant reduction in the proportion of women who died of any cause among those who received MHT compared with those who were untreated (RR 0.75, 95% 95% confidence interval CI: 0.65–0.86). The results were not statistically significant for the proportion of women with a cause of death attributable to CRC (RR 0.72, 95% CI: 0.52–1.02) because of the discrepancy between estimates from prospective (RR 0.75, 95% CI: 0.46–1.23) and retrospective studies (RR 0.63, 95% CI: 0.40–0.97). This risk reduction is evident during MHT treatment but not after the end of treatment. Treatments with estrogen alone appear to be associated with better outcomes than those with estrogen and progestin.
Comment: Level of evidence is downgraded due to the observational study design of the original trials.