Large-scale hormone replacement therapy and life expectancy: Results from an international comparison among European and north American populations

Objectives. An analysis was performed to determine the risks and benefits o f a 10-year hormone replacement therapy regimen that had been applied to al l women at 50 years of age in 8 countries. Methods. Cumulative mortality with and without hormone replacement therapy over 20 years was estimated, with both current and predicted total and dise ase-specific secular mortality trends and the influence of a generational c ohort effect taken into account. Results. In countries with high ischemic heart disease frequency and predic table relative predominance of ischemic heart disease rates over breast can cer rates for the neat 20 years, hormone replacement therapy could result i n benefits with regard to overall mortality; this advantage decreases in yo unger-generation cohorts. In countries in which breast cancer mortality pre dominates over ischemic heart disease in early postmenopause and in which t he predictable trends for both diseases reinforce this condition. a negativ e effect on overall mortality would be observed. In the United States, the effect of large-scale hormone replacement therapy would change over time. Conclusions. The long-term effect of hormone replacement therapy on life ex pectancy of postmenopausal women may vary among countries.