Pathology of the Colon and Ovary

Abstract

The question of a potential relationship between HRT and the occurrence of ovarian carcinoma is addressed. Because 50%–60% of nonmucinous carcinomas have oestrogen receptors, in principle a relationship is possible. A recent publication by Risch (2002) reviewed 20 studies which were completely different in size, outcome, and exposure, so that no real comparison is possible. Risch found that “for every study showing a positive association, there are 3 which show no association.” Five of the studies reviewed showed a slightly increased risk associated with HRT. The question here is whether this is due to induction or due to a previously undiscovered ovarian carcinoma which becomes apparent when on hormone therapy.

All studies reviewed have shown a reduced risk of colon cancer associated with HRT treatment. These findings are plausible from a biopathological perspective, because while normal colon mucosa contains oestrogen receptors, these are methylated, meaning that they are inactive. Oestrogen stabilizes this methylation; therefore a risk reduction can be assumed. Professor Dietel concluded that on the basis of this evidence, HRT can be given to patients with colon cancer.