Do Healthy Asymptomatic Postmenopausal Women with a Uterus Want Routine Cyclical Hormone Replacement? A Utility Analysis

Summary

Hormone replacement therapy is associated with many benefits but these must be traded off against a small increased risk of breast cancer. Women's views on the benefits of risks of routine prophylactic cyclical hormone replacement were measured using utility analysis in 110 subjects.

Subjects were consistent and gave similar answers to related questions (P < 0001). Women were coherent (P < 0.01 and < 0.001 for each scenario) but would only accept a small increase in risk to gain other substantial benefits. They demanded considerable proved benefits from osteoarthritis and cardiovascular disease to avoid a small increase in risk from breast cancer. Even if the most optimistic figures from the literature are used, the majority of women do not consider routine prophylactic hormone replacement therapy worthwhile. The inconvenience of prolonged pill taking and continued menstruation is not the major concern. It is the possibility that hormone replacement therapy might increase the risk of breast cancer that prevents women from accepting treatment.