Hormone replacement therapy, cancer, controversies, and women's health: Historical, epidemiological, biological, clinical, and advocacy perspectives

Nancy Krieger, Ilana Löwy, Robert Aronowitz, Judyann Bigby, Kay Dickersin, Elizabeth Garner, Jean Paul Gaudillière, Carolina Hinestrosa, Ruth Hubbard, Paula A. Johnson, Stacey A. Missmer, Judy Norsigian, Cynthia Pearson, Charles E. Rosenberg, Lynn Rosenberg, Barbara G. Rosenkrantz, Barbara Seaman, Carlos Sonnenschein, Ana M. Soto, Joe ThorntonGeorge Weisz

Research output: Contribution to journalReview articlepeer-review

Abstract

Routine acceptance of use of hormone replacement therapy (HRT) was shattered in 2002 when results of the largest HRT randomised clinical trial, the women's health initiative, indicated that long term use of oestrogen plus progestin HRT not only was associated with increased risk of cancer but, contrary to expectations, did not decrease, and may have increased, risk of cardiovascular disease. In June 2004 a group of historians, epidemiologists, biologists, clinicians, and women's health advocates met to discuss the scientific and social context of and response to these findings. It was found that understanding the evolving and contending knowledge on hormones and health requires: (1) considering its societal context, including the impact of the pharmaceutical industry, the biomedical emphasis on individualised risk and preventive medicine, and the gendering of hormones; and (2) asking why, for four decades, since the mid-1960s, were millions of women prescribed powerful pharmacological agents already demonstrated, three decades earlier, to be carcinogenic? Answering this question requires engaging with core issues of accountability, complexity, fear of mortality, and the conduct of socially responsible science.

Original languageEnglish (US)
Pages (from-to)740-748
Number of pages9
JournalJournal of epidemiology and community health
Volume59
Issue number9
DOIs
StatePublished - Sep 2005
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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