Department of Obstetrics and Gynecology, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730, China.
Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Hebei, 050000, China.
Arch Gynecol Obstet. 2021 Nov;304(5):1353-1361. doi: 10.1007/s00404-021-06052-4. Epub 2021 Apr 4.
The application of menopausal hormone therapy (MHT) is generally restricted most likely due to limited prescriptions by doctors. Fear of cancer risk may be a critical factor. We investigated the views of Chinese obstetricians and gynecologists on the relationship between hormone therapy and cancer risk.
A self-administered web-based nationwide cross-sectional questionnaire.
In total, 5243 medical workers responded to the questionnaire (response rate 94.5%); 4995 were certified obstetricians and gynecologists. Most were aged 36-55 years (70.9%), had > 10 years of working experience (68.5%), and worked at tertiary (34.8%) and secondary hospitals (49.1%); 70% of the clinicians were aware of the endometrial cancer risk caused by estrogen, and 20% considered progestogen to cause the same risk. Regarding breast cancer, while 67.9 and 74.8% of the clinicians viewed natural and synthetic estrogens as risk factors, respectively, only 41.7% identified the carcinogenic effect of progestins as higher than that of progesterone (26.7%). Approximately 75% of the participants believed synthetic estrogens and progestins constituted a risk for ovarian cancer (higher than the percentages for their natural counterparts); 13.0-21.1% of the respondents were worried about choriocarcinoma due to hormone treatment. Finally, 86.8% of obstetricians and gynecologists claimed to have poor knowledge regarding this field.
Misconceptions and a lack of knowledge in this regard may result in the fear of cancer and could be the underlying causes of limited MHT prescriptions. We believe that scientific research, continued education, and the media all have roles to play in changing preconceived ideas regarding MHT prescriptions.
由于医生开具的处方有限，绝经激素治疗（MHT）的应用通常受到限制。对癌症风险的担忧可能是一个关键因素。我们调查了中国妇产科医生对激素治疗与癌症风险之间关系的看法。
采用自我管理的网络全国横断面问卷调查。
共有 5243 名医务人员对问卷做出了回应（应答率 94.5%）；其中 4995 名为认证妇产科医生。他们大多数年龄在 36-55 岁（70.9%），有超过 10 年的工作经验（68.5%），工作于三级（34.8%）和二级医院（49.1%）；70%的临床医生了解雌激素引起的子宫内膜癌风险，20%认为孕激素也会引起同样的风险。关于乳腺癌，虽然 67.9%和 74.8%的临床医生分别认为天然雌激素和合成雌激素是危险因素，但只有 41.7%的人认为孕激素的致癌作用高于孕酮（26.7%）。大约 75%的参与者认为合成雌激素和孕激素构成了卵巢癌的风险（高于天然雌激素和孕激素的比例）；13.0-21.1%的受访者担心激素治疗会导致绒毛膜癌。最后，86.8%的妇产科医生表示对这一领域的知识掌握较差。
在这方面的误解和缺乏知识可能导致对癌症的恐惧，这可能是限制 MHT 处方的潜在原因。我们认为，科学研究、继续教育和媒体都可以在改变对 MHT 处方的先入为主的观念方面发挥作用。
