The WHI (Women's Health Initiative) trial of combined continuous HRT (conjugated equine oestrogen + medroxyprogesterone acetate) showed increased risk of which specific complication that led to its premature termination?
- A Endometrial carcinoma
- B Ovarian carcinoma only
- C Invasive breast cancer, coronary heart disease, stroke, and pulmonary embolism ✓
- D Colorectal carcinoma
Correct answer: C. Invasive breast cancer, coronary heart disease, stroke, and pulmonary embolism
Explanation
The WHI combined HRT arm (CEE + MPA) was stopped prematurely in 2002 because the combination increased risks of invasive breast cancer (hazard ratio 1.26), coronary heart disease (HR 1.29), stroke (HR 1.41), and pulmonary embolism (HR 2.13) in postmenopausal women. Conversely, it reduced colorectal cancer and hip fracture risk. Endometrial cancer risk is not increased with combined HRT but is increased with unopposed oestrogen alone (oestrogen-only arm was continued).
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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