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Significant new findings on blood and breast cancers
Emerging news could have important implications for GPs and their patients.
An international study led by Oxford University has found a strong link between use of menopausal hormone therapy (MHT) and risk of developing breast cancer.
The study, recently published in The Lancet, analysed results from 58 studies across the world involving more than 500,000 women, and compared rates of breast cancer in women who had used particular types of MHT versus women who had never used MHT.
According to the report, women in ‘western countries’ who do not use MHT had a 6.3% chance of developing breast cancer between the ages of 50–69. But the risk increased by a further 2% for women using oestrogen and daily progestogen therapy for five years starting at age 50, while the risk increased by 1.4%for those using oestrogen and intermittent progestogen.
Overall, women using MHT for 1–4 years had a 60% higher chance of breast cancer than those who had never used it. (There was little increased risk for less than one year of use.)
The study also found that excess duration-dependent risks persisted for more than a decade after ceasing use of MHT.
While the findings have, perhaps understandably, led to concern among patients about whether to take up, or continue, MHT, it is still regarded as often the most effective treatment for symptoms of menopause.
Many medical organisations are urging patients consult with their GPs before making any decisions regarding treatment, as there are a number of factors to consider when assessing cancer risk.
‘It’s very hard to make a blanket suggestion for all women across the population because, as women and as clinicians, we need to take into account individual risk factors [including a family history of the disease] and a women’s preference for treatment to make those decisions in a collaborative fashion,’ oncologist Professor Kelly-Anne Phillips told The Age.
The findings have also led experts to suggest that use of MHT extending for longer than one year should be carefully considered.
Meanwhile, a new report released by the Leukaemia Foundation (the Foundation) has revealed the impacts of blood cancer on the Australian population to be far greater than previously realised.
Blood cancers have traditionally been reported in Australia by major sub-types, which include leukaemia, lymphoma and myeloma, a method that has led to an underestimation of their incidence and rates of mortality.
But the State of the nation: Blood cancer in Australia report has found that, collectively, blood cancers represent one of the most common types of cancer in the country – and one of the most common causes of cancer death, across all age groups.
‘Every day, 41 Australian children, adults, parents and grandparents will be told they have blood cancer and, unfortunately, 20 people will lose their life to blood cancer, making these cancers some of the most common and deadly in the country,’ Chief Executive of the Leukaemia Foundation, Bill Petch, said.
Furthermore, the Foundation’s analysis of blood cancer statistics from the Australian Institute of Health and Welfare (AIHW) has shown that incidence of the disease has increased by more than 80% over the past 20 years. This has been attributed to an ageing population and improved methods of diagnosis, as well as potential genetic and environmental factors that may require further exploration.
The Foundation also cautions that if current trends continue without intervention, increasing numbers of people will be affected.
‘This report shows that by 2035 these figures will more than double, with close to 100 people a day set to be diagnosed and more than 40 people expected to die every day,’ Mr Petch said.
In response, the Federal Government has launched a national Blood Cancer Taskforce that will bring together clinicians, researchers and industry and patient groups to develop a national action plan.
The plan will, among other tasks, address equity of access to diagnosis and treatment of blood cancers, a key issue identified in the Foundation’s report from a survey of more than 3200 people living with blood cancer.
‘There are significant differences in treatment and survival outcomes depending on where a person lives, so it’s really important that we work together with Australia’s leading experts, Government and the blood cancer community to develop a plan to beat blood cancer,’ Mr Petch said.
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