64-612: The Million Women Study is a study of women’s health analysing data from more than one million women aged 50 and over, led by Dame Valerie Beral and a team of researchers at the Cancer Epidemiology Unit, University of Oxford . It is a collaborative project between Cancer Research UK and the National Health Service (NHS), with additional funding from the Medical Research Council (UK) . One key focus of
128-525: A 1.3 fold risk. Use of HRT by women aged 50–64 in the UK in the decade from 1993-2003 was estimated to have caused 20,000 extra breast cancers. Past users were not seen as having increased risk. A reanalysis refuting the initial conclusion that HRT increased the risk of breast cancer, was published in a 2012 paper in the Journal of Family Planning and Reproductive Health Care . The paper's authors, led by Samuel Shapiro of
192-565: A 2014 report in the National Survey on Drug Use and Health found that only 10% of either "heavy drinkers" or "binge drinkers" defined according to the above criteria also met the criteria for alcohol dependence, while only 1.3% of non-binge drinkers met the criteria. An inference drawn from this study is that evidence-based policy strategies and clinical preventive services may effectively reduce binge drinking without requiring addiction treatment in most cases. The therapeutic index for ethanol
256-495: A 2022 study, recreational heavy drinking and intoxication have become increasingly prevalent among Nigerian youth in Benin City. Traditionally, alcohol use was more accepted for men, while youth drinking was often taboo. Today, many young people engage in heavy drinking for pleasure and excitement. Peer networks encourage this behavior through rituals that promote intoxication and provide care for inebriated friends. The findings suggest
320-479: A 2024 WHO report indicates that these harmful consequences of alcohol use result in approximately 2.6 million deaths annually, accounting for 4.7% of all global deaths. In 2023, the WHO declared that 'there is no safe amount of alcohol consumption' and that 'the risk to the drinker’s health starts from the first drop of any alcoholic beverage.' This new global health policy aligns with the scientific consensus regarding
384-718: A decline in quality of life and a shortened lifespan by 3–6 years. Alcohol-based sugar-sweetened beverages , are closely linked to episodic drinking in adolescents. Sugar-infused alcoholic beverages include alcopops , and liqueurs . The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of alcohol consumption that brings a person's blood alcohol concentration (BAC) to 0.08 percent or above. This typically occurs when men consume five or more US standard drinks , or women consume four or more drinks, within about two hours. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines binge drinking slightly differently, focusing on
448-462: A deficiency of thiamine can produce Korsakoff's syndrome , which is associated with serious brain damage. Christian views on alcohol encompass a range of perspectives regarding the consumption of alcoholic beverages, with significant emphasis on moderation rather than total abstinence. The moderationist position is held by Roman Catholics and Eastern Orthodox , and within Protestantism, it
512-652: A figure of 6.93 kilocalories (29.0 kJ) per gram of alcohol (5.47 kcal or 22.9 kJ per ml) for calculating food energy. For distilled spirits , a standard serving in the United States is 44 ml (1.5 US fl oz), which at 40% ethanol (80 proof ), would be 14 grams and 98 calories. However, alcoholic drinks are considered empty calorie foods because other than food energy they contribute no essential nutrients . Alcohol increases insulin response to glucose promoting fat storage and hindering carb/fat burning oxidation. This excess processing in
576-411: A glass a day can be good for the heart. But there's more to the story. No research has proved a cause-and-effect link between drinking alcohol and better heart health." In folk medicine , consuming a nightcap is for the purpose of inducing sleep . However, alcohol is not recommended by many doctors as a sleep aid because it interferes with sleep quality . " Hair of the dog ", short for "hair of
640-445: A higher demand for alcohol compared to those who drink solely for recreation or self-medication. This finding raises concerns, as this group may be more likely to develop alcohol use disorder and experience negative consequences related to their drinking. A significant proportion of patients attending mental health services for conditions including anxiety disorders such as panic disorder or social phobia have developed these conditions as
704-489: A long association of military use, and has been called "liquid courage" for its role in preparing troops for battle, anaesthetize injured soldiers, and celebrate military victories . It has also served as a coping mechanism for combat stress reactions and a means of decompression from combat to everyday life. However, this reliance on alcohol can have negative consequences for physical and mental health. Military and veteran populations face significant challenges in addressing
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#1732881211531768-406: A major global public health issue and includes alcoholism , abuse , alcohol withdrawal , fetal alcohol spectrum disorder (FASD), liver disease , hepatitis , cardiovascular disease (e.g., cardiomyopathy ), polyneuropathy , alcoholic hallucinosis , long-term impact on the brain (e.g., brain damage , dementia , and Marchiafava–Bignami disease ), and cancers . For roughly two decades,
832-440: A need to reconsider cultural prohibitions on youth drinking and advocate for public health interventions promoting low-risk drinking practices. Heavy alcohol use is defined differently by various health organizations. The CDC defines "Current heavier drinker" as consuming more than 7 drinks per week for women and more than 14 drinks per week for men. Additionally, "Heavy drinking day (also referred to as episodic heavy drinking"
896-661: A number of years. From there she moved to direct the Cancer Research UK Cancer Epidemiology Unit at the University of Oxford in 1989. Beral said of being offered the role: "One of the major deterrents when I was offered the ICRF job in 1989 was the thought of being so much in the public eye. It's not my nature." Beral served on various international committees for the World Health Organization and
960-518: A parallel decrease in incidence of breast cancer was also reported between 2003 and 2007. A recent report assessing breast cancer incidence in Belgium between 2007 and 2008 also showed a significant drop in breast cancer incidence attributed to the decrease in HRT use in Belgium during and leading up 2008. Valerie Beral Dame Valerie Beral AC DBE FRS FRCOG FMedSci (28 July 1946 – 26 August 2022)
1024-477: A particular focus on the effects of hormone replacement therapy (HRT). It is the largest such study in the world with one in four of UK women in the target age group participating. In August 2003, Beral's group published results showing that taking HRT increases a woman's risk of developing breast cancer with an estimated 20,000 UK women aged 50–64 having possibly developed the disease between 1993 and 2003 due to HRT use. The study also showed that risk increases
1088-550: A result of recreational alcohol or sedative use. Self-medication or mental disorders may make people not decline their drinking despite negative consequences. This can create a cycle of dependence that is difficult to break without addressing the underlying mental health issue. The American Heart Association warn that "We've all seen the headlines about studies associating light or moderate drinking with health benefits and reduced mortality. Some researchers have suggested there are health benefits from wine, especially red wine, and that
1152-408: A spontaneous abortion, is the death and expulsion of an embryo or fetus before it can survive independently. Alcohol consumption is a risk factor for miscarriage. Drinking of alcohol by parents is linked to sudden infant death syndrome (SIDS). One study found a positive correlation between the two during New Years celebrations and weekends. Another found that alcohol use disorder was linked to
1216-405: Is 10%. Alcohol can have analgesic (pain-relieving) effects, which is why some people with chronic pain turn to alcohol to self-medicate and try to alleviate their physical discomfort. People with social anxiety disorder commonly self-medicate with alcohol to overcome their highly set inhibitions. However, self-medicating excessively for prolonged periods of time with alcohol often makes
1280-490: Is a central nervous system (CNS) depressant , decreasing electrical activity of neurons in the brain. The World Health Organization (WHO) classifies alcohol as a toxic , psychoactive, dependence -producing, and carcinogenic substance. Alcohol is found in fermented beverages such as beer, wine, and distilled spirit – in particular, rectified spirit , and serves various purposes; Certain religions integrate alcohol into their spiritual practices. For example,
1344-452: Is a medical term for ethanol solutions with 95% ABV . When taken by mouth or injected into a vein ethanol is used to treat methanol or ethylene glycol toxicity when fomepizole is not available. Ethanol, when used to treat or prevent methanol and/or ethylene glycol toxicity, competes with other alcohols for the alcohol dehydrogenase enzyme, lessening metabolism into toxic aldehyde and carboxylic acid derivatives, and reducing
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#17328812115311408-631: Is accepted by Anglicans , Lutherans and many Reformed churches . Moderationism is also accepted by Jehovah's Witnesses . Spiritual use of moderate alcohol consumption is also found in some religions and schools with esoteric influences, including the Hindu tantra sect Aghori , in the Sufi Bektashi Order and Alevi Jem ceremonies, in the Rarámuri religion, in the Japanese religion Shinto , by
1472-412: Is characterized as having 4 or more drinks on a single occasion for women and 5 or more for men, in the past year. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides gender-specific guidelines for heavy drinking. According to NIAAA, men who consume five or more US standard drinks in a single day or 15 or more drinks within a week are considered heavy drinkers. For women, the threshold
1536-787: Is classified as a teratogen —a substance known to cause birth defects; according to the U.S. Centers for Disease Control and Prevention (CDC), alcohol consumption by women who are not using birth control increases the risk of fetal alcohol spectrum disorders (FASDs). This group of conditions encompasses fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol-related neurodevelopmental disorder, static encephalopathy, and alcohol-related birth defects. The CDC currently recommends complete abstinence from alcoholic beverages for women of child-bearing age who are pregnant, trying to become pregnant, or are sexually active and not using birth control. In South Africa, some populations have rates as high as 9%. Miscarriage , also known in medical terms as
1600-426: Is considered to be an anaphrodisiac . Albeit not a valid intoxication defense , weakening the inhibitions by drunkenness is occasionally used as a tool to commit planned offenses such as property crimes including theft and robbery, and violent crimes including assault, murder, or rape – which sometimes but not always occurs in alcohol-facilitated sexual assaults where the victim is also drugged. Alcohol has
1664-541: Is drinking alcoholic beverages with an intention of becoming intoxicated by heavy consumption of alcohol over a short period of time, but definitions vary considerably. Binge drinking is a style of drinking that is popular in several countries worldwide, and overlaps somewhat with social drinking since it is often done in groups. Drinking games involve consuming alcohol as part of the gameplay. They can be risky because they can encourage people to drink more than they intended to. Recent studies link binge drinking habits to
1728-555: Is lower, with four or more drinks in a day or eight or more drinks per week classified as heavy drinking. In contrast, the Substance Abuse and Mental Health Services Administration (SAMHSA) takes a different approach to defining heavy alcohol use. SAMHSA considers heavy alcohol use to be engaging in binge drinking behaviors on five or more days within a month. This definition focuses more on the frequency of excessive drinking episodes rather than specific drink counts. Despite this risk,
1792-476: Is often used as "liquid courage" in the hookup culture , for them to make a sexual advance in the first place. However, a recent trend called "dry dating" is gaining popularity to replace "liquid courage", which involves going on dates without consuming alcohol. Consuming alcohol prior to visiting female sex workers is a common practice among some men. Sex workers often resort to using drugs and alcohol to cope with stress. Alcohol when consumed in high doses
1856-443: Is substantially greater for combined ( estrogen - progestogen ) HRT than for estrogen-only HRT; and that the effects were similar for all specific types and doses of estrogen and progestogen, for oral, transdermal and implanted HRT, and for continuous and sequential patterns of use. Current users of estrogen-progestogen HRT were at 2 fold increased risk of developing breast cancer, and current users of estrogen-only HRT appeared to have
1920-898: The Catholic Church requires alcoholic sacramental wine in the Eucharist , and permits moderate consumption of alcohol in daily life as a means of experiencing joy. Alcohol is also used as a recreational drug , for example by college students , for self-medication , and in warfare . It is also frequently involved in alcohol-related crimes such as drunk driving , public intoxication , and underage drinking . Short-term effects from moderate consumption include relaxation , decreased social inhibition , and euphoria , while binge drinking may result in cognitive impairment , blackout , and hangover . Excessive alcohol intake causes alcohol poisoning , characterized by unconsciousness or, in severe cases, death. Long-term effects are considered to be
1984-500: The Commission on Human Medicines . Public awareness of the study and its findings has led to significant behavioural changes, predominately resulting in the swift decline of HRT prescriptions throughout Europe and the US from 2003. In contrast to the increase in HRT prescriptions between 1991 and 1996, which remained stable through to 2001, sales of HRT fell by 50% between 2002 and 2005 following
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2048-567: The International Agency for Research on Cancer (IARC) of the WHO has classified alcohol as a Group 1 Carcinogen . Globally, alcohol use was the seventh leading risk factor for both deaths and DALY in 2016. According to WHO's Global status report on alcohol and health 2018, more than 200 health issues are associated with harmful alcohol consumption, ranging from liver diseases, road injuries and violence, to cancers, cardiovascular diseases, suicides, tuberculosis , and HIV/AIDS . Moreover,
2112-584: The London School of Hygiene and Tropical Medicine . There she completed a combined course in Epidemiology & Statistics in 1971–72 under the tutorship of Donald Reid . Beral felt very comfortable with the move because she had never felt happy in clinical medicine. She says that "she had never been able to understand how her peers could be so certain about making decisions on incomplete evidence. Epidemiology has offered her not an escape from that uncertainty, but
2176-646: The United States National Academy of Sciences . She also chaired the Department of Health 's Advisory Committee on Breast Cancer Screening. Beral was one of the leaders of the Million Women Study which was opened in 1997, and has recruited more than 1.3 million UK women over 50 via the NHS breast screening centres. The study is investigating how a woman's reproductive history can affect her health, with
2240-405: The University of Cape Town , claimed that the study had not in fact establish a causal relationship between HRT and breast cancer, and that the original analysis had been flawed. It is well known that post-menopausal women who have not had a hysterectomy are at increased risk of cancer of the endometrium (the lining of the womb) if they take estrogen-only HRT. Follow up of over 700 000 women in
2304-514: The University of Sydney in 1969. Beral then spent six months travelling the " hippie trail " through Asia of which she said "That taught me how much I wanted to work. But I still wanted to leave Australia." She then travelled to England and successfully applied for a job at the Hammersmith Hospital . At Hammersmith Hospital, she worked under Charles Fletcher, who recognised that she was suited to epidemiology and so propelled her towards
2368-466: The Million Women Study confirmed this and showed that the risk of endometrial cancer is also increased in women who take tibolone; but is not altered, or may even be reduced, in women taking combined estrogen-progestogen HRT. These effects depend also on a woman’s body mass index (BMI, a measure of obesity) such that adverse effects of tibolone and estrogen-only HRT are greatest in thinner women, and
2432-412: The UK. At these centres, women received a study questionnaire with their invitation, which they were asked to complete and return at the time of screening. Around 70% of those attending the programme returned questionnaires and agreed to take part in the study, over 1 in 4 women in the UK in the target age group. The Million Women Study is the largest study of its kind in the world. The Million Women Study
2496-450: The age of 76, after a year-long illness. She was survived by her husband, their two sons, two grandchildren, and her sister. Alcohol (drug) Alcohol (from Arabic al-kuḥl 'the kohl '), sometimes referred to by the chemical name ethanol , is the second most consumed psychoactive drug globally behind caffeine , and alcohol use disorders are the most prevalent of all substance use disorders worldwide. Alcohol
2560-601: The beneficial effects of combined HRT are greatest in fatter women. Results of the study show a small increase in risk of ovarian cancer in women taking HRT. Such an increased risk had been suspected from some previous studies, and has now been confirmed with the larger numbers available in this study. The findings come from analyses on 948,576 post-menopausal women in the study, followed up for about 5 years. Women currently taking HRT were at higher risk of developing and of dying from ovarian cancer than women not using HRT. Past users were not at increased risk. The risk in current users
2624-623: The co-occurrence of PTSD and alcohol use disorder . Military personnel who show symptoms of PTSD, major depressive disorder , alcohol use disorder, and generalized anxiety disorder show higher levels of suicidal ideation . Alcohol consumption in the US Military is higher than any other profession, according to CDC data from 2013–2017. The Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel published that 47% of active duty members engage in binge drinking, with another 20% engaging in heavy drinking in
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2688-841: The dog that bit you", is a colloquial expression in the English language predominantly used to refer to alcohol that is consumed as a hangover remedy (with the aim of lessening the effects of a hangover ). Many other languages have their own phrase to describe the same concept. The idea may have some basis in science in the difference between ethanol and methanol metabolism. Instead of alcohol, rehydration before going to bed or during hangover may relieve dehydration -associated symptoms such as thirst, dizziness, dry mouth, and headache. Drinking alcohol may cause subclinical immunosuppression . Dutch courage , also known as pot-valiance or liquid courage, refers to courage gained from intoxication with alcohol. Alcohol use among college students
2752-526: The drinking habits of 541 students over two football seasons. It revealed that high-profile game days ranked among the heaviest drinking occasions, similar to New Year's Eve. Male students increased their consumption for all games, while socially active female students drank heavily during away games. Lighter drinkers also showed a higher likelihood of risky behaviors during away games as their intoxication increased. This research highlights specific drinking patterns linked to collegiate sports events. According to
2816-506: The effects of radiation, breast cancer trials and screening, AIDS, gene therapy , Hiroshima survivors, Chernobyl , food toxins, and much else. The British Medical Journal described her tally of jobs, publications, and committees as reading "like a checklist of the epidemiological causes célebres of the past three decades". Beral completed her training in 1972 and began working for the London School of Hygiene and Tropical Medicine for
2880-446: The estimate is for the number of cancers to be increased to about 31. The overall increased risk is higher in women using combined estrogen-progestogen HRT than in women using estrogen-only HRT because most of the overall increase is due to an increase in breast cancer, and users of combined HRT have a higher risk of breast cancer than users of estrogen-only HRT. The study has also found that low to moderate alcohol consumption increases
2944-498: The fact that it increases the blood alcohol content (BAC). However, alcohol is a significant source of food energy for individuals with alcoholism and those who engage in binge drinking; For example, individuals with drunkorexia , engage in the combination of self-imposed malnutrition and binge drinking to avoid weight gain from alcohol, to save money for purchasing alcohol, and to facilitate alcohol intoxication. Also, in alcoholics who get most of their daily calories from alcohol,
3008-417: The liver acetyl CoA can lead to fatty liver disease and eventually alcoholic liver disease . This progression can lead to further complications, alcohol-related liver disease may cause exocrine pancreatic insufficiency , the inability to properly digest food due to a lack or reduction of digestive enzymes made by the pancreas. The use of alcohol as a staple food source is considered inconvenient due to
3072-565: The longer a woman uses HRT, but drops to the normal level within five years after stopping use. Beral lived in Oxford with her American husband, Paul Fine, who worked at the London School of Hygiene and Tropical Medicine. Beral maintained close links with Australia but "could not imagine returning to live there". Aside from concerns that Australia would hold little for her partner, she joked that "The population's too small!" to satisfy her needs as an epidemiologist. Beral died on 26 August 2022, at
3136-401: The more serious toxic effects of the glycols when crystallized in the kidneys . Drinking culture is the set of traditions and social behaviors that surround the consumption of alcoholic beverages as a recreational drug and social lubricant . Although alcoholic beverages and social attitudes toward drinking vary around the world, nearly every civilization has independently discovered
3200-561: The new religious movement Thelema , in Vajrayana Buddhism , and in Vodou faith of Haiti. In the US, alcohol is subject to the FDA drug labeling Pregnancy Category X ( Contraindicated in pregnancy ). Minnesota, North Dakota, Oklahoma, South Dakota, and Wisconsin have laws that allow the state to involuntarily commit pregnant women to treatment if they abuse alcohol during pregnancy. Ethanol
3264-492: The number of drinks consumed on a single occasion. According to SAMHSA, binge drinking is consuming five or more drinks for men, or four or more drinks for women, on the same occasion on at least one day in the past month. Light drinking, moderate drinking, responsible drinking, and social drinking are often used interchangeably, but with slightly different connotations: A 2007 study at the University of Texas at Austin monitored
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#17328812115313328-550: The opportunity to tackle it head on." She was a member of the Royal College of Physicians . One of Beral's first epidemiological interests was the combined oral contraceptive pill because of work she had previously done in family planning. Beral moved on to other projects but this is an area in which the data have yet to provide support for her initial instinct that the contraceptive pill, like pregnancy, will eventually be shown to protect against breast cancer. Later work included
3392-486: The past 30 days. Reports from the Russian invasion of Ukraine in 2022 and since suggested that Russian soldiers are drinking significant amount of alcohol (as well as consuming harder drugs), which increases their losses. Some reports suggest that on occasion, alcohol and drugs have been provided to the lower quality troops by their commanders, in order to facilitate their use as expendable cannon fodder . The USDA uses
3456-526: The prescribing and use of hormone replacement therapy from the Royal College of Obstetricians and Gynaecologists and from the Commission on Human Medicines . The Million Women Study is a multi-centre, population-based prospective cohort study of women aged 50 and over invited to routine breast cancer screening in the UK. Between 1996 and 2001, women were invited to join the Million Women Study when they received their invitation to attend breast screening at one of 66 participating NHS Breast Screening Centres in
3520-687: The processes of brewing beer, fermenting wine and distilling spirits . Common drinking styles include moderate drinking, social drinking, and binge drinking . In today's society, there is a growing awareness of this, reflected in the variety of approaches to alcohol use, each emphasizing responsible choices. Sober curious describes a mindset or approach where someone is consciously choosing to reduce or eliminate alcohol consumption, not drinking and driving, being aware of your surroundings, not pressuring others to drink, and being able to quit anytime. However, they are not necessarily committed to complete sobriety. Binge drinking, or heavy episodic drinking,
3584-568: The publication of the Million Women Study and the Women's Health Initiative study. A number of recent studies have shown that the Million Women Study continues to impact women’s health and behavioural patterns in Europe. Research examining breast cancer incidence trends in Sweden between 1997 and 2007, showed that the prevalence of HRT use in women aged 50–59 years decreased from a peak of 36% in 1999 to 9% in 2007,
3648-478: The results need to be looked at in the context of the other risks and benefits of HRT. In particular, an estimation of the overall effect of HRT use on three common cancers in women: breast cancer, endometrial (womb) cancer and ovarian cancer. Together, these cancers account for about 4 in 10 cancers in women in the UK. According to the findings, in women aged 50–69, about 19 of these cancers will develop over 5 years in every 1000 women not taking HRT. In women taking HRT
3712-522: The risk of a variety of types of cancer in women, including breast cancer . Results from the Million Women Study, together with those from other studies such as the Women’s Health Initiative trial from the USA, have influenced national policy, including recent recommendations on the prescribing and use of hormone replacement therapy from the Royal College of Obstetricians and Gynaecologists and from
3776-470: The risks of alcohol consumption for pregnant women, particularly due to FASDs , as well as for individuals under the legal drinking age . Additionally, this social change also reflects the temperance movement 's opposition to alcohol consumption and is supported by national public health agencies, which increasingly recommend abstinence in their alcohol consumption recommendations while noting that any alcohol intake raises risk levels. Spiritus fortis
3840-526: The study relates to the effects of hormone replacement therapy use on women's health. The study has confirmed the findings in the Women's Health Initiative (WHI) that women currently using HRT are more likely to develop breast cancer than those who are not using HRT. Results from the Million Women Study, together with those of the WHI trial from the USA, have influenced national policy, including recent recommendations on
3904-589: The symptoms of anxiety or depression worse. This is believed to occur as a result of the changes in brain chemistry from long-term use. A 2023 systematic review highlights the non-addictive use of alcohol for managing developmental issues , personality traits, and psychiatric symptoms , emphasizing the need for informed, harm-controlled approaches to alcohol consumption within a personalized health policy framework. A 2023 study suggests that people who drink for both recreational enjoyment and therapeutic reasons, like relieving pain and anxiety/depression/stress, have
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#17328812115313968-618: Was an Australian-born British epidemiologist , academic and a preeminent specialist in breast cancer epidemiology . She was Professor of Epidemiology, a Fellow of Green Templeton College, Oxford and was the Head of the Cancer Epidemiology Unit at the University of Oxford and Cancer Research UK from 1989. Valerie Beral was born in Australia on 28 July 1946. She completed her MBBS degree graduating with first-class honours from
4032-598: Was increased about 1.2 fold; for every 1000 women using HRT, 2.6 developed ovarian cancer over 5 years, compared with 2.2 in those not taking HRT. The risk was the same for estrogen-only, combined estrogen-progestogen and other types of HRT (including tibolone) and did not vary by specific type of estrogen or progestogen, or between oral and transdermal (patch) administration. These results are equivalent to one extra case of ovarian cancer for every 2500 women taking HRT, and one extra death from ovarian cancer per 3300 women taking HRT, over 5 years. Publishers of these studies say that
4096-552: Was set up with the aim of recruiting 1,000,000 women in the UK into a cohort study, to provide answers to the following questions: Initial analysis of the results from over 1 million women in the Million Women Study appeared to confirm preliminary findings from other studies at the turn of the century finding that women currently using progestin-estrogen HRT were more likely to develop breast cancer than those who are not using HRT. This initial analysis received extensive press coverage. The initial reading of results showed that this effect
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