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No cancer risk posed by long term low dose vaginal estrogen

Jan
10

Date: January 10th, 2019

A review on the large database showed that using unopposed topical vaginal estrogen wasn’t in any way associated with a higher risk of getting cancer or endometrial hyperplasia. Yearly incidence of diseases from 2006 to 2012 among women from Kaiser Permanente Northern California membership aged at least 46 years old didn’t show any significant differences by the number of vaginal estrogen prescriptions dispensed over a period of 3 years. This is according to the report given by Dr. Kathryn M. Gunnison at an annual meeting of American College of Obstetricians and Gynecologists.

The incidence rates as reported

As per their findings, the annual incidence per every 10000 women as reported was 1.86- 18.23 for those who got at least four prescriptions and between 7.29 and 15.01 for those who got between one and three prescriptions and between 8.74 and 10.86 for those who didn’t get any prescriptions. The groups had overall incidence rates of 9.96, 10.25 and 9.96 respectively per 10000 women as noted in the research. When reaching these conclusions, the researchers used Kaiser Permanente Northern California Cancer Registry and ICD-9 codes in their efforts of identifying the first dates of the cancer or endometrial hyperplasia in the annual population. There was also a review of the pharmacy records as a way of identifying dispensed prescriptions for vaginal estrogen in the three years before the cancer or endometrial hyperplasia was diagnosed. The researchers essentially excluded women who were exposed within two years before the diagnosis as well as those who had used systemic estrogen.

Concerns about vaginal estrogen

The selection criteria were essentially men by women between 450000 and 530000 every year during the time that the study was undertaken. In addition, there was a slight increase on how vaginal estrogen was used over the period of the study. Women ranging from 26000 to 34000 filled between one and three prescriptions during the years of the study while between 9300 and 23000 of them filed at least four prescriptions.

In overall, the annual incidence of cancer or endometrial hyperplasia over the period of the study increased and this was consistent with the national data. There was a rise in the incidence from 8.96 per every 10000 women in 2006 all the way to 10.56 in every 10000 women by 2012 even though there was no significant difference when it came to the number of the filled prescriptions. Going by the data available, the researchers concluded that using unopposed topical vaginal estrogen didn’t feature any association with increased risk for cancer or endometrial hyperplasia over the period of the 3 years. There is need for further studies. The study available currently has been limited by retrospective and descriptive study design and also that the method in which estrogen was delivered wasn’t examined.

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