Which disease is associated with an increased risk when using estrogen-only therapy in postmenopausal women?

• A. Breast cancer
• B. Endometrial cancer
• C. Cervical cancer
• D. Ovarian cancer

Answer: (B)

Estrogen-only therapy in postmenopausal women is particularly associated with an increased risk of endometrial cancer. Estrogen can stimulate the growth of the endometrium (the lining of the uterus). In women who have not had a hysterectomy, unopposed estrogen therapy can lead to hyperplasia of the endometrial tissue, which increases the risk of developing cancer. This is why healthcare providers often recommend that progestins be used alongside estrogen in women with an intact uterus to mitigate this risk.

Breast, cervical, and ovarian cancers have different risk profiles associated with hormone therapy. For instance, while there is some association between hormone therapy and breast cancer, the link is more significant with combined estrogen and progestin therapy. Cervical cancer risk is typically related to HPV infection rather than hormone therapy. Ovarian cancer risks are not as directly correlated with estrogen-only therapy as they are with other hormonal treatments, reflecting a more complex relationship that may depend on multiple factors.

Understanding the specific interactions between estrogen therapy and the various types of cancer is crucial for appropriately managing postmenopausal women's health and individualizing treatment options.