Burger C W, Koomen I, Peters N A, van Leeuwen F E, Kenemans P
Academisch Ziekenhuis, afd. Verloskunde en Gynaecologie, Amsterdam.
Ned Tijdschr Geneeskd. 1997 Feb 22;141(8):368-72.
Oestrogen replacement therapy (ORT) significantly increases the relative risk (RR) of endometrial cancer, especially long-term oestrogen use (RR: 9.5; 95% confidence interval (CI): 7.4-12.3). Addition of a progestin to ORT reduces this increased risk completely or largely. The risk of breast cancer is increased after ORT of 5 years or longer (RR: 1.23; 95% CI: 1.08-1.40). Addition of a progestin does not reduce this increased risk. The possibility cannot be excluded that long-term ORT increases the risk of epithelial ovarian cancer. No significant association between ORT and cervical cancer has been demonstrated. It is safe to prescribe ORT for a period shorter than 5 years for women with menopausal symptoms. Addition of a progestin is indicated when the uterus is in situ. Hormonal supplementation therapy is to be discouraged in women treated for breast cancer, may be considered in young women previously treated for endometrial or ovarian cancer with a good prognosis and severe menopausal symptoms and is justified in women previously treated for cervical cancer.
雌激素替代疗法（ORT）显著增加子宫内膜癌的相对风险（RR），尤其是长期使用雌激素时（RR：9.5；95%置信区间（CI）：7.4 - 12.3）。在ORT中添加孕激素可完全或很大程度上降低这种增加的风险。5年及以上的ORT后乳腺癌风险增加（RR：1.23；95%CI：1.08 - 1.40）。添加孕激素并不能降低这种增加的风险。不能排除长期ORT会增加上皮性卵巢癌风险的可能性。未证实ORT与宫颈癌之间存在显著关联。对于有更年期症状的女性，开具为期短于5年的ORT是安全的。子宫存在时需添加孕激素。乳腺癌治疗后的女性不建议进行激素补充疗法，对于既往因子宫内膜癌或卵巢癌接受治疗且预后良好但有严重更年期症状的年轻女性可考虑使用，而对于既往因宫颈癌接受治疗的女性则有理由使用。
