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Hormone replacement therapy linked to lung cancer deaths

Jun 03, 2009

The use of hormone-replacement therapy for menopause for five years or more increases the risk of dying from lung cancer by 60%, U.S. researchers reported on Saturday. For smokers, the trial found that use of Prempro, Wyeth's combined estrogen/progestin hormone-replacement therapy, caused an extra death from non-small cell lung cancer for each 100 women during the study.

Doctors once thought that hormone therapy, or HRT, could protect women from chronic diseases, especially heart disease. But use of the drugs plunged after 2002 when the large Women's Health Initiative study found that HRT could raise the risk not only of breast and ovarian cancer, but of strokes and other serious conditions.

The findings are based on secondary analyses of a study of 16,608 menopausal women in good health by the US government known as the Women's Health Initiative. Researchers sought to evaluate the effects of Prempro, a combination of estrogen and progestin (a synthetic form of progesterone), sold by the US pharmaceutical giant Wyeth. The analysis focused on the incidence of the most common form of lung cancer and its mortality rate over a period of nearly 5.5 years comparing women who followed the hormonal treatment and another group that took placebos. There was no significant difference between the two groups in the rate of lung cancer, but the mortality rate after the diagnosis was two times higher among the women that were using hormone replacement therapy. The menopausal woman who got lung cancer and followed hormonal treatment had a 61% higher chance of dying from the disease than the other women in the study. While breast cancer is the most common cancer in US women, lung cancer is the leading cause of cancer death among US women.

“Women almost certainly shouldn't be using hormone replacement therapy and tobacco at the same time,” said Dr. Rowan Chlebowski, a medical oncologist at Harbor-UCLA Medical Center in Los Angeles and lead author of the study, which analyzed data from the WHI trial. The study was presented at the 45th annual meeting of the American Society of Clinical Oncology (ASCO), the biggest global cancer conference.

Heartburn drugs may raise risk of hip fractures

Even short-term use of popular acid-reducing heartburn drugs used to treat GERD and ulcer disease likely raise the risk of hip fractures, U.S. researchers said this Monday. The increased risks appeared two years after patients started taking proton pump inhibitors such as Prevacid, Nexium, Prilosec, Protonix and Aciphex and histamine-2 receptor antagonists such as Zantac, according to the researchers at Kaiser Permanente San Francisco.

A recent study in the Canadian Medical Association Journal suggested long-term use of proton pump inhibitors -- for at least five years -- may raise the risk of hip fractures. Dr. Douglas Corley, who led the study, said in a statement “the increased risk with short-term use of acid-suppressing drugs suggests that even relatively brief periods of use may be associated with increased risk of hip fractures.”

For the study, Corley and colleagues analyzed data on nearly 40,000 patients taking acid-reducing drugs, and compared them to more than 130,000 patients not taking the drugs. Patients who had hip fractures were 30% more likely to have taken proton pump inhibitors for at least two years and 18% more likely to have taken histamine-2 receptor antagonists for at least two years. Risks were lower in people who had taken lower doses. Those who took less than one pill a day had a 12% increase in fracture risk. Patients who took one pill per day had a 30% increased risk, while those who took more than one pill a day had a 41% higher risk. People aged 50 to 59 who had been on proton pump inhibitors for more than two years had the biggest increase in fracture risk with taking the drugs, they said. The researchers presented their findings this week in Chicago at the Digestive Diseases Week meeting.