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To the Editor: Dr Heiss and colleagues¹ studied the health risks and benefits after stopping estrogen and progestin for participants in the Women's Health Initiative (WHI) trial. They reported that the lower risk of colorectal cancer that had been observed in women prescribed conjugated equine estrogens plus medroxyprogesterone acetate compared with women assigned to placebo during the trial phase had disappeared within 3 years of discontinuing hormone replacement therapy.

In colorectal cancer screening studies, women have had a lower prevalence of adenomatous polyps and cancer than men. In one study, 11% of women and 19% of men were found to have adenomatous polyps or cancer on screening colonoscopies.² High-grade neoplasia (cancer or adenoma at least 1 cm in size, villous component, or high-grade dysplasia) was found on screening colonoscopy in 4.3% of women and 8.0% of men with no family history of colorectal cancer.² The most important implication of the . . . [Full Text of this Article]

Timothy W. Odell, MD
timothy.odell@hsc.utah.edu
Department of Medicine
University of Utah
Salt Lake City

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Health Risks and Benefits 3 Years After Stopping Randomized Treatment With Estrogen and Progestin
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