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In Reply: Regarding Dr Kuhl's concern about the early stopping of our trial, we regret that the WHI cannot provide more definitive data on the effects of CEE on breast cancer including longer-term use, or on potential benefits for CHD, since these questions provided the primary motivation for our trial. It remains possible that CEE may have reduced CHD rates in women aged 50 to 59 years at enrollment, but our data cannot resolve this issue. We disagree with Kuhl's concern about the relevance of our sample, however, as the women in WHI represent the very women for whom CHD primary prevention would be considered.

The comparison of WHI results for CEE and estrogen-plus-progestin¹ clearly casts suspicion on progestin as having a key role in the increase of breast cancer cases observed in the combined hormone trial. The suggestion of an effect of prior hormone use in the estrogen-plus-progestin trial . . . [Full Text of this Article]

Garnet L. Anderson, PhD
garnet@whi.org
WHI Clinical Coordinating Center
Seattle, Wash
For the WHI Steering Committee

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