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Mammogram checks linked to HRT use

Declining use of HRT has contributed to a drop in mammogram checks for breast cancer, study shows.

Menopausal women who stop using hormone replacement therapy (HRT) are likely to start skipping mammogram checks for breast cancer, a study suggests.

Startling research published in 2002 about a rise in breast cancer among women on HRT sparked a huge drop in the use of the treatment to control hot flushes and other menopausal symptoms.

But what researchers in the United States also began noticing in the years after the study was published was a slide in the number of women having regular mammograms.

To investigate whether there was a link they examined more than 7000 women about their HRT use and mammogram checks between 2000 and 2005.

The National Cancer Institute researchers found the change in HRT use was associated with the drop in mammogram checks for women aged 50 to 64.

Women were more likely to have had regular mammograms if they were on HRT, regularly spoke with a GP, were well educated and had private health insurance, they said.

The researchers believed that because HRT was prescribed by GPs, women using the treatment made more regular visits to their doctor and so heard constant reminders about having mammograms.

Once they stopped using HRT, they might not have been getting as many reminders from their GPs about mammograms and were less likely to remember to have the checks.

"Our research corroborates that a doctor's recommendation is an important step in getting a mammogram and it shows that when circumstances change - such as evidence about HRT - it can upset the balance and lead to unanticipated and undesirable changes in mammography use," the study's lead author Nancy Breen said.

Breastscreen Victoria chief executive said work was underway in Australia to develop an alert system for GPs to remind them to ask women about whether they had had a mammogram.

"If you go to your GP for something else, up would come your file on their computer screen and a message saying that the woman hasn't had their mammogram," she told AAP.

"When we are looking at our data we know 15 per cent of women who come for screening do so because their GPs have recommended it."

Australian women aged between 40 and 70 are entitled to have free mammograms every two years to check for breast cancer, the leading cause of cancer-related death in women.

However, the checks are considered crucial for 50-69 year olds because half of all breast cancers diagnosed are detected in that age group.

While HRT use has been linked to breast cancer and other adverse effects, advocates argue that drinking alcohol, being overweight and having your first child after the age of 35 are higher risk factors for the disease than HRT.

Drug regulators in Australia, the US and Europe recommend HRT only be used to control menopausal symptoms and that all women should be fully informed of the risks.


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