What is the evidence linking ERT with the first development of endometrial cancer?

Several large studies have found that women who take estrogen without progestins have a higher risk of developing endometrial cancer than women who do not use ERT. The risk for estrogen users is estimated to be 5 to 10 times higher than that for nonusers.

What is the evidence that ERT does not cause a recurrence of endometrial cancer?

Two studies have looked at data from groups of endometrial cancer survivors who used ERT. In one study, scientists analyzed data for 221 patients with stage I endometrial cancer, 47 of whom received estrogen for about 26 months after the tumor was removed. This study found that the cancer recurred in 15 percent of the women who did not receive estrogen and in 2 percent of those who did take estrogen.

In the other study, scientists analyzed data from 144 women who had stage I endometrial cancer, including 45 who were at low risk of recurrence and who had taken ERT for about 64 months. None of the estrogen users in this study had the cancer recur.

How will the new study be carried out?

More than 2,000 women who have had recent surgery for early stage uterine cancer (stage I or II) will take part in the study. Participants will be divided randomly (as in a flip of a coin) into two groups. One group will receive pills containing estrogen and the other will receive identical-appearing pills that do not contain estrogen (a placebo) for 3 years. The study is double-blinded—that is, neither physicians nor patients will know which women are taking the placebo and which are taking estrogen. Women in both groups will have check-ups every 6 months for 3 years and then annually for 2 more years.

Who is eligible for this study?

Women with endometrial cancer who were treated with a total hysterectomy and bilateral salpingo-oophorectomy and found to be at surgical stage IA, IB, IC, IIA, or IIB may be eligible for this study. These women must have at least one indication for ERT, including hot flashes, vaginal atrophy (dryness), increased risk of cardiovascular disease, or increased risk of osteoporosis. Women must have recovered from the effects of the recent surgery and be entered in the study within 12 weeks of surgery.

Ten Important Facts To Know About Cancer

1. Don't use tobacco. If you do, quit. This is the single most important thing you can do to prevent cancer.

2. Eat at least five servings of fruits and vegetables each day. Fruits and vegetables may lower your risk for some kinds of cancer.

3. If you are a woman, age 50 or older, get a mammogram every one to two years.

4. There is no upper age limit for the Pap test. Even women who have gone through menopause should have regular checkups, including a pelvic exam and a Pap test.

5. Cancers of the colon and rectum are more likely to occur as people get older. Three tests can help find these cancers early: rectal exam, guaiac stool test, and sigmoidoscopy. Ask your doctor how often you should have these tests.

6. Prostate cancer is the most common cancer in American men, especially older men. Discuss with your doctor early detection tests and their benefits and drawbacks.

7. Avoid too much sunlight; wear protective clothing; use sunscreen.

8. Avoid unnecessary x-rays.

9. If you do have cancer, find out what your treatment choices are and which are best for you. And before getting treatment, get a second opinion from another doctor.

What You Need To Know About Cancer of the Colon and Rectum

Introduction

The diagnosis of cancer of the colon or rectum, also called colorectal cancer, raises many questions and a need for clear, understandable answers. We hope this National Cancer Institute (NCI) booklet will help. It provides information on the symptoms, detection and diagnosis, and treatment, in addition to information on possible causes and prevention of cancers of the colon and rectum. Having this important information can make it easier for patients and their families to handle the challenges they face.

Together, cancers of the colon and rectum are among the most common cancers in the United States. They occur in both men and women and are most often found among people who are over the age of 50.

Cancer research has led to real progress against colorectal cancer -- a lower chance of death and an improved quality of life for people with this disease. The Cancer Information Service and the other NCI resources listed in the "National Cancer Institute Information Resources" section can provide the latest, most accurate information on colorectal cancer. Publications mentioned in this booklet and others are available from the Cancer Information Service at 1-800-4-CANCER. Many NCI publications are also available on the Internet at the Web sites listed in the "National Cancer Information Resources" section at the end of this booklet.