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Women who receive hormone replacement therapy with estrogen plus progestin may have an increased risk of developing lung cancer, according to a study published in the Journal of Clinical Oncology.[1]

Hormone replacement therapy (HRT) is often prescribed for women during menopause, which is a natural phase of the female lifecycle during which the ovaries produce significantly less estrogen, ovulation ceases, and menstruation ends. For many women, menopause has uncomfortable side effects such as hot flashes, sleep disturbances, depression, mood swings, and anxiety. Additionally, menopause may also be accompanied by increased urinary tract infections, incontinence, vaginal discomfort due to a lack of estrogen-based lubrication, and decreased bone density. 

Although HRT has been widely prescribed for menopausal women, it has come under scrutiny because it may be linked to increased incidence of certain types of cancer and other health problems. Combined HRT is linked with an increased risk of breast cancer, heart disease, stroke, and blood clots, but a decreased risk of colorectal cancer and fractures. Researchers continue to evaluate single-agent HRT and combined HRT to determine the risks and benefits of its use.  Risks are thought to outweigh the benefits for most women. Among these risks is a potentially increased risk of dying from lung cancer, which was reported by the Women’s Health Initiative study.[2]

To further explore the relationship between HRT and lung cancer, researchers evaluated information from the Vitamins and Lifestyle [VITAL] Study. This study enrolled 36,588 women from Washington State who were aged 50 to 76. Among study participants, 344 cases of lung cancer were identified. 

  • Use of combined HRT for one to nine years was associated with a 27% increased risk of lung cancer.
  • Use of combined HRT for 10 or more years was associated with a 48% increased risk of lung cancer.
  • HRT with estrogen only was not associated with an increased risk of lung cancer.
  • Longer duration of combined HRT use was associated with diagnosis of lung cancer at a more-advanced stage.   

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The researchers concluded that risk of lung cancer increased among women with increasing duration of use of combined HRT.  As well, women using combined HRT for longer periods had more-advanced stage lung cancer at diagnosis. 

Women considering combined HRT for management of menopausal symptoms are encouraged to consider the risks and benefits of this therapy.


[1] Slatore CG, Chien JW, Au DH, et al. Lung cancer and hormone replacement therapy: Association in the Vitamins and Lifestyle Study. Journal of Clinical Oncology. 2010;28:1540-1546.

[2] Chlebowski RT, Schwartz AG, Wakelee H, et al. Estrogen plus progestin and lung cancer in postmenopausal women (Women’s Health Initiative trial): A post-hoc analysis of a randomized controlled trial. The Lancet [early online publication]. September 20, 2009. DOI: 10.1016/S0140-6737(09)61526-9.

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