Gambrell R D
Maturitas. 1978 Sep;1(2):107-12. doi: 10.1016/0378-5122(78)90017-8.
Due to adverse publicity alleging an increased risk of endometrial cancer with estrogen therapy, a prospective study was begun in 1976 to determine the incidence of this disease in postmenopausal women. During 5,025 patient-years of observation in 1976-1977, 6 adenocarcinomas of the endometrium were diagnosed for an incidence of 1.2:1,000 postmenopausal women per year. No endometrial malignancies were detected in 2,552 patient years of therapy with estrogens and progestogens. In 1,028 patient-years of observation where estrogens only was the therapy, there were 3 endometrial cancers for an incidence of 2.9:1,000. Adenocarcinoma of the endometrium was found in 2 of the untreated group, which gave an incidence of 3.0:1,000. The sixth endometrial cancer occurred in a patient using estrogen vaginal cream. During this same period, 139 perimenopausal and postmenopausal women were treated with progestogens for endometrial hyperplasia. The hyperplasia was reversed to normal endometrium in 133 patients (95.7%). Hyperplasia is a precancerous lesion and should be treated with either progestogens or hysterectomy. All postmenopausal women with a uterus should be given the Progestogen Challenge Test and the progestogen continued each month as long as bleeding follows. These methods will prevent most endometrial cancers.
由于有负面报道称雌激素疗法会增加子宫内膜癌风险，1976年启动了一项前瞻性研究，以确定绝经后女性中这种疾病的发病率。在1976年至1977年的5025个患者年观察期内，诊断出6例子宫内膜腺癌，发病率为每年每1000名绝经后女性中有1.2例。在2552个使用雌激素和孕激素治疗的患者年中未检测到子宫内膜恶性肿瘤。在仅使用雌激素治疗的1028个患者年观察期内，有3例子宫内膜癌，发病率为每1000名中有2.9例。在未治疗组中有2例发现子宫内膜腺癌，发病率为每1000名中有3.0例。第六例子宫内膜癌发生在一名使用雌激素阴道乳膏的患者身上。在同一时期，139名围绝经期和绝经后女性因子宫内膜增生接受了孕激素治疗。133名患者（95.7%）的增生逆转至正常子宫内膜。增生是一种癌前病变，应使用孕激素或子宫切除术进行治疗。所有有子宫的绝经后女性都应接受孕激素激发试验，只要有出血，每月持续使用孕激素。这些方法将预防大多数子宫内膜癌。
