Hormone replacement therapy and cervical cancer: a systematic review of the literature

Abstract

Gynecological tumor treatment, including cervical cancer (CC) treatment, often leads to iatrogenic premature menopause. This highlights the critical importance of investigating indications for hormone replacement therapy (HRT), as most patients, thanks to the improvement in diagnosis and treatment, have to deal with the sequelae of their cancer treatments for many years. This systematic review aims to provide an overview of the current knowledge regarding the risks of HRT and CC. In particular, we aim to investigate whether the use of HRT can increase CC incidence, and evaluate its risk in CC survivors. A systematic review, in agreement with PRISMA guidelines, of the English literature present in PubMed and SCOPUS has been performed. A total of 2805 articles have been screened, of which 10 were considered eligible. Several studies reported a significantly reduced risk of developing cervical squamous cell carcinoma in postmenopausal women treated with HRT, while a weak increase in the incidence of adenocarcinoma has been shown. No evidence reports a harmful effect of HRT on CC oncological outcome, while several benefits, in terms of reduced metabolic risk and increased quality of life, have been described, thus concluding that HRT should be offered to young CC survivors for the management of early menopause.

摘要

妇科肿瘤的治疗, 包括宫颈癌（CC）的治疗, 往往导致医源性的早绝经。这就突出了研究激素替代治疗（HRT）适应证的重要性, 由于诊断和治疗的改善, 大多数患者都需要解决肿瘤治疗的后遗症问题。本系统性综述概述了目前关于HRT和CC风险的知识。特别的是, 我们旨在调查HRT是否可以增加CC的发生率, 并评估其在CC幸存者中的风险。根据PRISMA指南, 对PubMed和SCOPUS中存在的英文文献进行系统性回顾。共筛选了2805篇文章, 其中10篇符合条件。几项研究表明, 接受HRT治疗的绝经后女性发生宫颈鳞状细胞癌的风险显著降低, 而腺癌的发病率则有微弱增加。没有证据表明激素替代治疗法对CC肿瘤预后有不良影响, 但也有一些益处, 如减少代谢风险和提高生活质量, 因此得出结论, 应该为年轻的CC幸存者提供激素替代治疗, 用于早期绝经的管理。

Keywords:

• Hormone replacement therapy
• cervical cancer
• premature menopause

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Source of funding

Nil.