Are Hormones and Cancer Linked?

COLONOSCOPY

"Get a routine colonoscopy whether or not you are taking hormone therapy after menopause." That is the primary message women should take away from research by the Women’s Health Initiative on the relationship of estrogen and progestin replacement and colon cancer, states study co-author Jean Wactawski-Wende of the University at Buffalo (N.Y.).

Results indicate that, while there were fewer colon cancers among women in the treatment group than among those taking a placebo, colon cancers that did develop in the treatment group were more advanced when diagnosed, suggesting a poorer outcome.

"The results of the current study that show more advanced cancers in the treatment group are somewhat puzzling," says Wactawski- Wende, assistant professor of social and preventive medicine and gynecology and obstetrics. "We think it’s possible that women receiving estrogen and progestin may have attributed colon cancer symptoms, such as constipation, diarrhea, cramping, or stomach pain, to the hormone treatment, and delayed cancer screening. Or they may have been distracted from reporting potential symptoms of colon cancer by symptoms related to their [hormone replacement] therapy, such as vaginal bleeding.

"It’s also possible that the hormone treatment only prevents precancerous lesions from progressing. Study participants weren’t screened for colon cancer when they entered the study, and colon screening wasn’t part of the . . . activities, so we don’t know if those who were diagnosed with colon cancer during the study already had cancerous polyps."

However, "these results give us one more reason to talk about the importance of screening and colonoscopy," concludes Wactawski- Wende. "All women should consider a colonoscopy after 50, whether or not they take hormones."

Copyright Society for Advancement of Education Oct 2004