Hormonal substitution and extragenital neoplasia

The object of this study was to evaluate currently published data regarding extragenital neoplasia induced by HRT. Most of the epidemiological studies have calculated a 30-40% reduced risk of HRT and colorectal cancer. In current users of HRT,the reduction of colorectal cancer was more pronounced. Furthermore, this protective effect could be observed in colorectal adenomas which were of reduced incidence in women receiving HRT. Despite the known association of benign liver tumors (hepatocellular adenoma,focal nodular hyperplasia) and oral contraceptives (OC) in earlier studies, this effect was less pronounced with currently used low-dose OC. In the majority of studies, no increased relative risk of hepatocellular carcinoma was documented in OC users, including those with cyproterone acetate (CPA). It is interesting to note that postmenopausal hormone therapy was associated with a significantly diminished risk of liver and bile duct cancer. However current data do not support any effect of HRT on the incidence of kidney and lung cancer. There were not sufficient data to draw any definite conclusions concerning the risk of brain tumors, such as meningeomas. When summarizing available epidemiological, clinical and laboratory data, it can be stated that women with HRT or OC are not at increased risk of developing skin tumors and melanomas. Although thyroid cancer is more common in women at reproductive age, exogenous application of hormones had no effect on cancer incidence.