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More evidence of HRT-breast cancer link, says -

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ELEANOR HALL: The New South Wales Cancer Council has released a study which it says provides clear
evidence that women using hormone replacement therapy (HRT) are at an increased risk of developing
breast cancer.

But there's still division within the medical community about the dangers of HRT.

Some medical experts argue that more research is needed to prove a causal link between HRT and
breast cancer.

Sara Everingham reports.

SARA EVERINGHAM: In 2002 a US study found women using hormone replacement therapy had higher rates
of breast cancer, it prompted a sharp drop in the number of women using hormone replacement
therapy.

The New South Wales Cancer Council has been looking at how the drop in HRT use has affected
Australian women.

Dr Karen Canfell is an epidemiologist at the Cancer Council.

KAREN CANFELL: I think this study adds to the worldwide evidence that HRT does increase the risk of
breast cancer and the risk increases the longer women use HRT.

SARA EVERINGHAM: Last year the Cancer Council released a study showing up until 2003 the drop in
the use of HRT in Australia coincided with a drop in the rate of breast cancer.

What's new about this study is that they tracked the changes up until 2005.

KAREN CANFELL: From the peak of use of HRT and the peak of breast cancer, which occurred in 2001
until 2005, we saw a drop of HRT use by more than half in Australia.

And at the same time breast cancer rates in women over 50 years of age, which is the age groups
using HRT, dropped by nine per cent.

So that's actually 800 fewer women who are developing breast cancer every year and we think that
most of that reduction is due to the halving of the rate of HRT use.

SARA EVERINGHAM: But not everyone's convinced.

Professor Rob Norman is a reproductive health expert from the University of Adelaide

ROBERT NORMAN: Well we're seeing a continual release of studies showing the correlation between the
use of hormone therapy and its decline, with decrease in breast cancer.

What we need to recognise is that a correlation is the lowest form of medical evidence on which we
act.

It can be extremely useful to highlight an area that we didn't know about before, and then to do
proper studies, but to rely entirely on correlation like this is a dangerous matter.

SARA EVERINGHAM: The Cancer Council says it supports the policy of the Therapeutic Goods
Administration on HRT.

And that's that HRT does have a role to play in the management of moderate to severe menopausal
symptoms, but should only be used for the shortest time possible, with women to have checks every
six months with their GP.

Professor Rob Norman agrees HRT has a role to play in the treatment of menopausal symptoms.

He says what's needed now are trials to give a more definitive answer on the link between HRT and
breast cancer.

Although he says the confusion might be set to continue for some time.

ROBERT NORMAN: We need proper studies to look at the effects of hormone therapy or placebo around
the time of menopause for those women who really do need something.

And there are standard ways of doing that, randomised controlled trials are our gold standard
evidence.

It's hard to know whether anyone is going to fund that and obviously there will be some concern
about the safety of the studies.

But I think we don't have enough evidence in that time of life to know whether hormone therapy is a
problem.

ELEANOR HALL: That's Professor Norman, Rob Norman, a reproductive health expert from the University
of Adelaide, he was speaking to Sara Everingham.