Estrogen replacement therapy in patients with endometrial cancer: prescription attitude of Belgian gynecologists

Abstract

Background: Endometrial cancer is estrogen dependent and has been considered as a contraindication for HRT. Some uncontrolled studies reported no increase in recurrence in women who received ERT after they had suffered early stage endometrium cancer and many opinion leaders have mandated that early uterus cancer should not be considered as an absolute contraindication to HRT. Aim: We conducted a survey evaluating the prescription attitude of Belgian gynecologists ( n=1363) towards a case describing a patient who presents indication for ERT (climacteric symptoms and osteoporosis) and a past history of early stage endometrium cancer. Results: We obtained a 32% response rate. Overall, the physicians prescribed treatment in 67% of the cases. There was no difference in the prescription attitude in relation to gender or age of the physicians. Among the physicians who prescribed HRT, 49% stated that they would prescribe estrogen-only therapy (unopposed estrogens) and 27% would prescribe a combined estrogen-progestin therapy. Conclusion: Two out of three gynecologists, in Belgium, would accept, at least theoretically, to prescribe HRT to a woman with a history of early stage endometrial cancer, no signs of recurrence and recognized indications for HRT.