Hormone replacement therapy and cancer

During the last 25 years, the question of hormone replacement therapy (HRT) has been in focus. HRT has proved to reduce the risk of cardiovascular diseases and osteoporotic fractures substantially. However, controversies still remain as regards cancer risk when patients with a history of breast or endometrial cancer are prescribed HRT. Women who take progestins along with oestrogen are not at higher risk of developing endometrial cancer than postmenopausal women who do not take oestrogen are. An overall assessment indicates that long-term HRT may increase the risk of breast cancer slightly. Oestrogen users seem to have a lower risk of developing colon cancer. Prescribing HRT to selected women after a history of endometrial or breast cancer is no longer contra-indicated, but prospective randomised trials are required to test the effect of HRT on overall survival.