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  • Conduct of the Women's Health Initiative randomised trial evaluating estrogen plus progestin: implications for breast cancer findings: authors’ response

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Letters to the editor
Conduct of the Women's Health Initiative randomised trial evaluating estrogen plus progestin: implications for breast cancer findings: authors’ response
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  1. Samuel Shapiro, MB, FRCP(E)
  1. Visiting Professor of Epidemiology, Department of Epidemiology, University of Cape Town, Cape Town, South Africa; samshap@mweb.co.za
  1. Richard D T Farmer, MB, PhD
  1. Emeritus Professor of Epidemiology, Department of Epidemiology, University of Surrey, Guildford, UK; richard.farmer1@btopenworld.com
  1. John C Stevenson, FRCB. MFSEM
  1. Consultant Physician and Reader in Metabolic Medicine, National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, UK; j.stevenson@imperial.ac.uk
  1. Henry G Burger, MD, FRACP
  1. Emeritus Director, Prince Henry's Institute of Medical Research, Monash Medical Centre, Clayton, Victoria, Australia; Consultant Endocrinologist, Jean Hailes Medical Centre for Women's Health, Clayton, Victoria, Australia; henry.burger@princehenrys.org
  1. Alfred O Mueck, MD, PhD
  1. Professor of Clinical Pharmacology and Endocrinology, Department of Endocrinology, University Women's Hospital, Tubingen, Germany; anne.gompel@cch.aphp.fr
  1. Anne Gompel
  1. Professor of Gynaecology, Gynaecological Endocrinology Unit, Paris Descartes University, APHP, Port-Royal Hospital, Paris, France; anne.gompel@htd.aphp.fr

https://doi.org/10.1136/jfprhc-2013-100673

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    We thank Drs Chlebowski, Nikolaenko and Anderson for their comments.1

    We have previously reviewed2 the article published by Chlebowski and his colleagues in the New England Journal of Medicine,3 and the claim that it documented that “mammography use was similar in the hormone-therapy and placebo groups … before and after the intervention [i.e. the Women's Health Initiative (WHI) clinical trial]” is incorrect. Only the percentages of breast cancer that were detected by mammography were documented.

    In a subsequent article Chlebowski et al. 4 stated that “mammography frequency was comparable in the two randomization groups during the original trial period … (annualized percentage, 80% for hormone vs 80% for placebo). In the reconsenting population [i.e. women who consented for long-term follow-up after the protocol-specified trial period ended] … the percentages of women with one or more mammograms were also comparable … (86% for hormone vs 86% placebo [sic])”. However, the annual numbers, or the rates, of mammography among the women who stopped their treatments, either during the trial or thereafter, …

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