Reposição hormonal e câncer

ARTIGO ARTICLE

Terapia de reposição hormonal e o câncer do endométrio
Hormone replacement therapy and endometrial cancer

Naidilton Lantyer Cordeiro de Araújo Júnior 1
Daniel Abensur Athanazio 1,2

Abstract
1 Escola Bahiana de
Medicina e Saúde Pública,
Salvador, Brasil.
2 Centro de Pesquisa Gonçalo
Moniz, Fundação Oswaldo
Cruz, Salvador, Brasil.

Correspondência
D. A. Athanazio
Centro de Pesquisa Gonçalo
Moniz, Fundação Oswaldo
Cruz.
Rua Waldemar Falcão 121,
Salvador, BA
40296-710, Brasil. [e-mail] Introdução

Hormone replacement therapy (HRT) has been used worldwide to relieve menopausal symptoms. The evolution in clinical knowledge of its risks has lagged persistently behind its application in clinical practice. In the 1970s, endometrial cancer incidence increased in developed countries, and exogenous estrogen therapy in postmenopausal women was the most important factor. In the 1980s and 90s, combined estrogen-progesterone therapy was prescribed on a large scale, based on its potential beneficial effects on the musculoskeletal and cardiovascular systems without increasing the risk of endometrial carcinoma. However, once again, recent reports argue against the safety of HRT, and the most important issues are now the increased risk of cardiovascular disease and total cancer in combined formulations. We conclude that the recently reported risks on combined HRT may have a significant public health impact, and that this treatment regimen should not be prescribed to protect postmenopausal women from endometrial carcinoma, since the risks outweigh the benefits. A aplicação clínica da terapia de reposição hormonal (TRH) é um bom exemplo de como a evolução do conhecimento médico pode ser tortuosa, e como a comunidade médica e científica pode subestimar por considerável período os efeitos de algumas intervenções. O uso de hormônios para aliviar a sintomatologia relacionada à menopausa é amplamente