摘要
Objectives. - To compare the pre- existing risk profiles for breast or endometrial cancer of menopaused women receiving tibolone or another hormone replacement therapy in France, with a view to examining the possibility of biases of selection of patients and of detection of these cancers in the Million Women Study. Patients and methods. - Nationwide survey conducted in France among a representative sample of 153 gynaecologists. The particulars of the last two consulting menopaused women treated with tibolone (N=306) and of the last two treated with a classical estrogen- progestogen therapy (N=306) were collated then analysed. Results. - Compared to those treated with a classical estrogen- progestogen therapy, more women receiving tibolone were aged 60 years or over (40 vs 31% ; P < 0.01)- . More of them had risk factors for breast cancer (history of mastodynia or mastopathy, elevated mammographic breast density) (6 vs 50% ; P < 0.01). More of them had a history of uterine investigation or exploration or of irregular bleeding (61 vs 53% of women with a history of irregular bleeding; P < 0.05). Overall, 84% of women treated with tibolone had at least one risk factor for breast or endometrial cancer vs 75% of those receiving a classical estrogen-progestogen therapy (P < 0.01). Discussion and conclusion. - Owing to its specific properties, tibolone is generally prescribed to women with a higher risk profile for breast or endometrial cancer than those receiving a classical estrogen- progestogen therapy, which may entail patient selection and cancer detection biases in non- randomised, open- label, observational studies.
Objectives. -To compare the pre- existing risk profiles for breast or endometrial cancer of menopaused women receiving tibolone or another hormone replacement therapy in France, with a view to examining the possibility of biases of selection of patients and of detection of these cancers in the Million Women Study. Patients and methods. - Nationwide survey conducted in France among a representative sample of 153 gynaecologists. The particulars of the last two consulting menopaused women treated with tibolone （N = 306） and of the last two treated with a classical estrogen - progestogen therapy （N = 306） were collated then analysed. Results. - Compared to those treated with a classical estrogen- progestogen therapy, more women receiving tibolone were aged 60 years or over （40 vs 31%; P 〈0. 01 ） - . More of them had risk factors for breast cancer （history of mastodynia or mastopathy, elevated mammographic breast density） （6 vs 50%; P 〈 0. 01）. More of them had a history of uterine investigation or exploration or of irregular bleeding （61 vs 53% of women with a history of irregular bleeding; P 〈 0. 05）. Overall, 84% of women treated with tibolone had at least one risk factor for breast or endometrial cancer vs 75% of those receiving a classical estrogen-progestogen therapy （P 〈 0. 01） . Discussion and conclusion. - Owing to its specific properties, tibolone is generally prescribed to women with a higher risk profile for breast or endometrial cancer than those receiving a classical estrogen- progestogen therapy, which may entail patient selection and cancer detection biases in non- randomised, open- label, observational studies.
