Talk:Million Women Study

HRT & cancer good, but need other key findings - osteoporosis, smoking, etc.

This article needs significant additions to capture the full scope of the MWS, which can be glimpsed

here:

http://www.millionwomenstudy.org/publications/

See also:

http://www.millionwomenstudy.org/publications_other/

and here:

http://www.ncbi.nlm.nih.gov/pubmed?term=%22Million%20Women%20Study%20Collaborators%22

Ocdnctx (talk) 23:27, 2 May 2011 (UTC)

This key Lancet article says HRT study NOT confined to UK women, a basis on which it has been criticized

The Lancet, Volume 350, Issue 9084, Pages 1047 - 1059, 11 October 1997

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2897%2908233-0/fulltext

doi:10.1016/S0140-6736(97)08233-0Cite or Link Using DOI

Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52 705 women with breast cancer and 108 411 women without breast cancer

Collaborative Group on Hormonal Factors in Breast Cancer

Summary

Background

The Collaborative Group on Hormonal Factors in Breast Cancer has brought together and reanalysed about 90% of the worldwide epidemiological evidence on the relation between risk of breast cancer and use of hormone replacement therapy (HRT).

Methods

Individual data on 52 705 women with breast cancer and 108 411 women without breast cancer from 51 studies in 21 countries were collected, checked, and analysed centrally. The main analyses are based on 53 865 postmenopausal women with a known age at menopause, of whom 17 830 (33%) had used HRT at some time. The median age at first use was 48 years, and 34% of ever-users had used HRT for 5 years or longer. Estimates of the relative risk of breast cancer associated with the use of HRT were obtained after stratification of all analyses by study, age at diagnosis, time since menopause, body-mass index, parity, and the age a woman was when her first child was born.

Findings

Among current users of HRT or those who ceased use 1—4 years previously, the relative risk of having breast cancer diagnosed increased by a factor of 1·023 (95% CI 1·011—1·036; 2p=0·0002) for each year of use; the relative risk was 1·35 (1·21—1·49; 2p=0·00001) for women who had used HRT for 5 years or longer (average duration of use in this group 11 years). This increase is comparable with the effect on breast cancer of delaying menopause, since among never-users of HRT the relative risk of breast cancer increases by a factor of 1·028 (95% CI 1·021—1·034) for each year older at menopause. 5 or more years after cessation of HRT use, there was no significant excess of breast cancer overall or in relation to duration of use. These main findings did not vary between individual studies. Of the many factors examined that might affect the relation between breast cancer risk and use of HRT, only a woman's weight and body-mass index had a material effect: the increase in the relative risk of breast cancer associated with long durations of use in current and recent users was greater for women of lower than of higher weight or body-mass index. There was no marked variation in the results according to hormonal type or dose but little information was available about long durations of use of any specific preparation. Cancers diagnosed in women who had ever used HRT tended to be less advanced clinically than those diagnosed in never-users. In North America and Europe the cumulative incidence of breast cancer between the ages of 50 and 70 in never-users of HRT is about 45 per 1000 women. The cumulative excess numbers of breast cancers diagnosed between these ages per 1000 women who began use of HRT at age 50 and used it for 5, 10, and 15 years, respectively, are estimated to be 2 (95% CI 1—3), 6 (3—9), and 12 (5—20). Whether HRT affects mortality from breast cancer is not known.

Interpretation

The risk of having breast cancer diagnosed is increased in women using HRT and increases with increasing duration of use. This effect is reduced after cessation of use of HRT and has largely, if not wholly, disappeared after about 5 years. These findings should be considered in the context of the benefits and other risks associated with the use of —Preceding unsigned comment added by Ocdnctx (talk • contribs) 23:50, 2 May 2011 (UTC)

Article needs to address other many findings and papers flowing from MM women study

Smoking as a cancer risk in women.

Obesity as a cancer risk

Osteoporosis

Much, much more. Many areas, themes, —Preceding unsigned comment added by Ocdnctx (talk • contribs) 03:34, 22 May 2011 (UTC)

POV tag

Sorry to tag and run. I will come back to this and work on it to fix it, but I wanted to note that this article is incredibly promotional about this study and its impact. This was an Observational study and as such it has serious limitations. It is not taken into account, for example, in the AHRQ's 2012 recommendations for HRT use (PMID 22720332) - that report specifically says, "Observational studies were not included because of the existence of published RCTs designed to address the key questions directly, and the known biases inherent in observational studies of menopausal hormone use." Likewise, the 2012 Cochrane study {PMID 22786488) mentions the Million Women Study in the background section, but like all Cochrane reviews, it took into account only RCTs. This article really needs to be contextualized with the limitations that it was observational. Jytdog (talk) 06:15, 28 July 2015 (UTC)

Mis-represents the study as only about cancer. It was about much more.

Article needs addition of the many other health issues covered, and reference to the varied and prolific study results in many health fields.