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Open Access 01-12-2016 | Research

Progesterone vs. synthetic progestins and the risk of breast cancer: a systematic review and meta-analysis

Authors: Noor Asi, Khaled Mohammed, Qusay Haydour, Michael R. Gionfriddo, Oscar L. Morey Vargas, Larry J. Prokop, Stephanie S. Faubion, Mohammad Hassan Murad

Published in: Systematic Reviews | Issue 1/2016

Abstract

Background

Use of menopausal hormonal therapy (MHT)-containing estrogen and a synthetic progestin is associated with an increased risk of breast cancer. It is unclear if progesterone in combination with estrogen carries a lower risk of breast cancer. Limited data suggest differences between progesterone and progestins on cardiovascular risk factors, including cholesterol and glucose metabolism. Whether this translates to differences in cardiovascular outcomes is uncertain. We conducted a systematic review and meta-analysis to synthesize the existing evidence about the effect of progesterone in comparison to synthetic progestins, each in combination with estrogens, on the risk of breast cancer and cardiovascular events.

Methods

We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Scopus through 17 May 2016 for studies that enrolled postmenopausal women using progesterone vs. synthetic progestins and reported the outcomes of interest. Study selection and data extraction were performed by two independent reviewers. Meta-analysis was conducted using the random effects model.

Results

We included two cohort studies and one population-based case-control study out of 3410 citations identified by the search. The included studies enrolled 86,881 postmenopausal women with mean age of 59 years and follow-up range from 3 to 20 years. The overall risk of bias of the included cohort studies in the meta-analysis was moderate. There was no data on cardiovascular events. Progesterone was associated with lower breast cancer risk compared to synthetic progestins when each is given in combination with estrogen, relative risk 0.67; 95 % confidence interval 0.55–0.81.

Conclusions

Observational studies suggest that in menopausal women, estrogen and progesterone use may be associated with lower breast cancer risk compared to synthetic progestin.

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Title: Progesterone vs. synthetic progestins and the risk of breast cancer: a systematic review and meta-analysis
Authors: Noor Asi
Khaled Mohammed
Qusay Haydour
Michael R. Gionfriddo
Oscar L. Morey Vargas
Larry J. Prokop
Stephanie S. Faubion
Mohammad Hassan Murad
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Systematic Reviews / Issue 1/2016
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-016-0294-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Progesterone vs. synthetic progestins and the risk of breast cancer: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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