Editorial: Cancer risks from hormone treatment.

Abstract

The withdrawal from the market of the oral contraceptives Volidan 21 and Serial 28 was based on work in beagle dogs treated for 7 years with high doses of megestrol acetate. The treated animals developed significantly more tumors than untreated controls. Chlormadinone acetate was withdrawn from clinical use in 1970 on the basis of similar reports. All other progestogens in use in Britain had no effect on the incidence of tumors. The only neoplasm linked with oral contraceptives by clinical evidence is hepatic adenoma. In menopausal and postmenopausal patients estrogen therapy may increase the risk of endometrial uterine cancer. For most young women oral contraception is a compromise between safety and reliability. Serious thromboembolic complications increase with age, cigarette smoking, and hypertension. Patients should be screened for the presence of risk factors and the effects of treatment regularly assessed. In menopausal women, regular monitoring for endometrial cancer is advised. Medical supervision of hormone therapy is needed.