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Reductions in use of hormone replacement therapy: effects on Swedish breast cancer incidence trends only seen after several years

  • Epidemiology
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Abstract

Studies from Western countries have found evidence of a recent decline in breast cancer incidence rates in postmenopausal women, findings which have been hypothesized to reflect a reduced use of hormonal replacement therapy (HRT). We examined breast cancer incidence trends in Sweden between 1997 and 2007, a period characterized by a drop in the use of HRT. Incidence trends were assessed using data from three population-based Regional Clinical Registries on breast cancer covering 2/3 of the Swedish population. Information on HRT sales was obtained from national pharmacy data. The prevalence of HRT use in age group 50–59 years decreased from a peak of 36% in 1999 to 27% in 2002 and further to 9% in 2007. Incidence rates of breast cancer in women 50 years and older increased between 1997 and 2003. A significant decrease in incidence between 2003 and 2007 was confined to women 50–59 years of age, the group in which the prevalence of HRT use has been highest and the decrease in use most pronounced. As opposed to the immediate effects reported from the United States and other regions, there was a time lag between the drop in HRT use and clear reductions in breast cancer incidence. This may reflect between country differences with regard to types of HRT used, and the rate, magnitude and pattern of change in use. The present findings give further support to the notion that HRT use is a driver of breast cancer incidence trends on the population level.

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Acknowledgments

The study was supported by grants from the Swedish Council for Working life and Social research (#2007-214), Regional Research Council Uppsala-Örebro (#10316), and ALF Uppsala University Hospital (#43159).

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Authors and Affiliations

  1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden

    Mats Lambe

  2. Regional Oncologic Centre, Uppsala, Sweden

    Mats Lambe, Annette Wigertz & Marit Holmqvist

  3. Oncologic Centre Stockholm and Gotland, Karolinska University Hospital, Stockholm, Sweden

    Annette Wigertz & Jan Adolfsson

  4. Medical Product Agency, Uppsala, Sweden

    Carola Bardage, Viveca Odlind & Ingemar Persson

  5. Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden

    Tommy Fornander

  6. Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden

    Per Karlsson

  7. Department of Oncology and Centre for Research and Development, Uppsala University, Gävle Hospital, Gävle, Sweden

    Johan Ahlgren

  8. Department of Surgery and Centre for Clinical Research, Uppsala University, Central Hospital, Västerås, Sweden

    Leif Bergkvist

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  1. Mats Lambe
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Correspondence to Mats Lambe.

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Lambe, M., Wigertz, A., Holmqvist, M. et al. Reductions in use of hormone replacement therapy: effects on Swedish breast cancer incidence trends only seen after several years. Breast Cancer Res Treat 121, 679–683 (2010). https://doi.org/10.1007/s10549-009-0615-7

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  • DOI: https://doi.org/10.1007/s10549-009-0615-7

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