1. Endometrial and other cancers David W. Sturdee

2. Unopposed estrogen and endometrial cancer Smith19754.5 Ziel19755.6–7.6 Mack19768 Antunes19796–15 Jick197910 Hammond19793.8 Weiderpass19996.2 YearRisk ratio

3. < 5 years1.5 (1.0–2.2)0.8 (0.5–1.3) > 5 years2.9 (1.8–4.6)0.2 (0.1–0.8) Per year1.1 (1.06–1.15)0.86 (0.77–0.97) DurationSequential Continuous E + Pcombined HT and risk of endometrial cancer OR (95% CI) Weiderpass E, et al. J Natl Cancer Inst 1999;911:1131–7

4. Women’s HOPE, Women’s Health, Osteoporosis, Progestin, Estrogen; CEE, conjugated equine estrogens; MPA, medroxyprogesterone acetate Endometrial hyperplasia rates after 1 and 2 years of low-dose E + P Women’s HOPE Study Hyperplasia rate (%) 0.625 mg0.625/ 2.5 mg 0.45 mg0.45/ 2.5 mg 0.45/ 1.5 mg 0.3 mg0.3/ 1.5 mg Placebo CEECEE/MPA 0.00 Year 1 Year 2 Pickar JH, et al. Fertil Steril 2003;80:1234 – 40

5. Chlebowski RT, et al. N Engl J Med 2004;350:991 – 1004 WHI results: effect of HT on risk of colorectal cancer WHI results: effect of HT on risk of colorectal cancer Kaplan-Meier estimate HR = 0.56 95% nCI = 0.38–0.81 95% aCI = 0.33–0.94 Placebo E+P

6. WHI study: gynecological cancers (annualized %) CEE + Hazard95% OutcomeMPAPlaceborationCI n85068102 Duration (months)67.866.8 Ovary20 (0.04)12 (0.03)1.580.77–3.24 Endometrium27 (0.06)31 (0.07)0.810.48–1.36 Cervix8 (0.02)5 (0.01)1.440.47–4.42 Anderson GL, et al. JAMA 2003;290:1739 – 48