Patterns of use of hormone replacement therapy in one million women in Britain, 1996-2000
Abbott S., Bailey E., Baker K., Banks E., Barnes I., Balkwill A., Beral V., Black J., Bonner K., Brown A., Bull D., Burrile A., Cameron B., Clarke J., Cliff A., Crossley B., Dee J., Eastwood D., Ewart D., Gerrard L., Green J., Hilton E., Hogg A., Hooley J., Hurst A., Keene C., Kennedy C., Langston N., Lewis C., Mathie J., Pennington K., Reeves G., Reid S., Roden B., Sherman E., Simmonds M., Spencer E., Timadjer A., Warby S., Austoker J., English R., Patnick J., Peto R., Vessey M., Wallis M.
Objective: To describe national patterns of use of hormone replacement therapy (HRT) in 1996-2000. Design: Population-based study of women aged 50-64. Setting: England and Scotland. Population: A total of 1,091,250 women were recruited between May 1996 and December 2000. Methods: Women invited for screening at 66 NHS breast screening units were sent a questionnaire to complete before they were screened; 71% of women screened participated. Main outcome measures: Prevalence of use of HRT. Results: Overall, 33% of women reported that they were currently using HRT, the average duration of use being 5.8 years; 50% were ever-users. Current use of HRT was about twice as common at age 50-54 than 60-64, but varied little by time or region, the prevalences being 33%-34% in each year from 1996 to 2000; 30% in Scotland and 35% in southeast England. The prevalence of current use of HRT varied substantially depending on the woman's history of gynaecological surgery and past health, and was as follows in women with a history of: bilateral oophorectomy (66%); hysterectomy without bilateral oophorectomy (48%); neither hysterectomy nor bilateral oophorectomy (27%); breast cancer (6%); other cancer (25%); stroke (24%); venous thromboembolism (24%); diabetes (25%); heart disease (31%); or hypertension (31%). There was considerably less variation in the prevalence of use of HRT according to deprivation index, education, parity, body mass index, exercise, smoking or alcohol consumption. Conclusions: HRT is currently used by around one-third of women aged 50-64 in Britain and appears to be influenced considerably more strongly by a woman's medical and surgical history than by socio-economic or lifestyle factors.