Abstract
Objectives: The aim of the present cross-sectional analysis was to describe patterns and determinants
of use of hormone replacement therapy (HRT) in a large sample of women attending mammographic
screening. Methods: Between 1999 and 2001, 8533 women aged 50–70 years were recruited by 11 screening
centres, and structured interviews were made collecting information on socio-demographic
characteristics, lifestyle habits, medical and reproductive history (overall response
rate 87%). Results: Current HRT use was reported by 6.9% of women (n=585), the average duration of use being 3.5 years; 13.2% were ever HRT users. Binomial
and multinomial logistic regression (MLR) analyses showed that younger age, higher
educational level, past mammographic examination and history of bilateral oophorectomy
were the major predictors of current and ever HRT use. Current use was also more frequently
reported by women who were thinner, nulliparae, had had induced menopause, had a later
onset of menopause, with history of oral contraceptive use and hysterectomy without
bilateral oophorectomy. By contrast, those who were diabetics or had positive history
of cardiovascular disease were less likely to be current HRT users. No differences
were found in HRT use according to marital status, type of occupation, menopausal
status, smoking, history of breast cancer, hypercholesterolemia, hypertension and
phlebitis. Conclusions: Our results support previous findings indicating that HRT use in Italian women is
uncommon and of short duration. Current HRT users were less likely than non-users
to report several characteristics associated with higher mortality and morbidity,
in accordance with the healthy-user phenomenon described in other countries.
Keywords
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References
Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of Estrogen plus Progestin in healthy postmenopausal women. JAMA 2002;288:321–33.
- Evidence from randomised trials on the long-term effects of hormone replacement therapy.Lancet. 2002; 360: 942-944
- Cardiovascular disease outcomes during 6.8 years of hormone therapy. Heart and Estrogen/Progestin replacement study follow-up (HERS-II).JAMA. 2002; 288: 49-57
- Postmenopausal hormones—therapy for symptoms only.N. Eng. J. Med. 2003; 348: 1835-1837
- Making decisions about hormone replacement therapy.BMJ. 2003; 326: 322-326
- Oral estrogen replacement therapy versus placebo for hot flushes: a systematic review.Climacteric. 2001; 4: 58-74
- Perspectives in hormone replacement therapy.Maturitas. 2001; 38: S41-S48
- The changing view of hormone replacement therapy.Rev. Cardiovasc. Med. 2003; 4: 68-71
- Assessment of the QoL in Italian menopausal women: comparison between HRT users and non-users.Maturitas. 2002; 42: 267-280
Progetto Menopausa Italia Study Group. General and medical factors associated with hormone replacement therapy among women attending menopause clinics in Italy. Menopause 2001;8:290–95.
- Sociodemographic and clinical factors associated with HRT use in women attending menopause clinics in Italy.Climacteric. 2000; 3: 241-247
- Postmenopausal users of long-term hormonal replacement therapy: social-cultural features.Clin. Exp. Obstet. Gynecol. 1999; 26: 88-90
- Determinants of estrogen replacement therapy use in northern Italy.Rev. Epidemiol. Sante Pub. 1993; 41: 53-58
- Correlates of hormone replacement therapy use in Italian women, 1992–1996.Maturitas. 1999; 33: 107-115
- Determinants of elevated blood pressure in women around menopause: results from a cross-sectional study in Italy.Maturitas. 1999; 34: 25-32
- Prevalence and determinants of hormone replacement therapy in German women 1984–1995.Maturitas. 2002; 43: 95-104
- Prevalence and determinants of estrogen replacement therapy in elderly women.Am. J. Ostet. Gynecol. 1990; 163: 1438-1444
- Use of postmenopausal hormone replacement therapy: estimates from a nationally representative cohort study.Am. J. Epidemiol. 1997; 145: 536-545
- Self-rated health, life satisfaction and personal characteristics of post-menopausal women under estrogen replacement therapy.Maturitas. 2000; 35: 71-79
- Correlates of postmenopausal female hormone therapy.Obstet. Gynecol. 1998; 91: 454-458
- Correlates of postmenopausal estrogen use and trends through the 1980s in two southeastern New England communities.Am. J. Epidemiol. 1993; 137: 1125-1135
- Determinants of hormonal replacement therapy in recently postmenopausal women.Eur. J. Obstet. Gynecol. Reprod. Biol. 1992; 45: 193-200
- Sociological and behavioural characteristics of perimenopausal women with an express attitude to hormone substitution therapy.Maturitas. 1996; 23: 73-83
- Determinants of first prescription of hormone replacement therapy. A follow up study among 1689 women aged 45–60 years.Maturitas. 1995; 20: 81-89
- Factors determining the use of hormone replacement therapy in recent naturally postmenopausal women participating in the French S.U.,VI.MAX cohort.Eur. J. Epidemiol. 2000; 16: 477-482
Million Women Study Collaborators. Patterns of use of hormone replacement therapy in one million women in Britain, 1996–2000. BJOG 2002;109:1319–30.
- Hormone replacement therapy in Norwegian women, 1996–1997.Maturitas. 2001; 40: 131-140
- Prevalence of hormone replacement therapy and user’s characteristics: a community survey in Japan.Maturitas. 1996; 25: 201-207
- Hormone replacement therapy among Danish women aged 45–65 years: prevalence, determinants, and compliance.Obstet. Gynecol. 1997; 90: 269-277
- Hormone replacement therapy and major risk factors for reproductive cancers, osteoporosis, and cardiovascular diseases: evidence of confounding by exposure characteristics.J. Clin. Epidemiol. 1997; 50: 611-618
- Use of hormone replacement therapy bt postmenopausal women in the United States.Ann. Intern. Med. 1999; 130: 545-553
- Cardioprotective effect of hormone replacement therapy in postmenopausal women: is the evidence biased?.BMJ. 1994; 308: 1268-1269
- Understanding the divergent data on postmenopausal hormone therapy.N. Engl. J. Med. 2003; 348: 645-650
- Postmenopausal hormone therapy.N. Engl. J. Med. 2003; 348: 2363-2364
Staniscia T, Manzoli L, Di Giovanni P, Dragani V, Testa P, Cavaliere D, et al. Factors related to the uptake of breast cancer screening (mammography and breast ultrasound): a retrospective survey on a sample of resident women, 50–70 years aged, from Abruzzo Region. Ann Ig 15, 1063–75.
Salvini S, Staniscia T, Festi D, Franceschi S, Negri E, Romano F, et al. The validation study of the food frequency questionnaire adopted for the breast cancer screening in the Abruzzo Region, Italy: study description and preliminary results. Abstract presented at the 4th European Forum for Dieticians. Assisi, Italy; 2001.
- Interaction between the G1057D variant of IRS-2 and overweight in the pathogenesis of type 2 diabetes.Hum. Mol. Genet. 2000; 9: 2517-2521
- Weight change, body weight and mortality: the impact of smoking and ill health.Int. J. Epidemiol. 2001; 30: 777-786
ISTAT. Indagine Multiscopo sulle famiglie: Aspetti della vita quotidiana. Rome: ISTAT; 1999.
StataCorp. Stata Statistical Software: Release 6.0. College Station, TX: Stata Corporation; 1999.
- Breast cancer and post-menopausal hormone therapy.Best Pract. Res. Clin. Endocrinol. Metab. 2003; 17: 123-137
- Hormone replacement therapy: dilemmas in 2002.Trans. Am. Clin. Climatol. Assoc. 2003; 114: 233-240
- Hormone replacement therapy and accuracy of mammographic screening.Lancet. 2000; 355: 270-274
- Agreement between general practice prescription data and self-reported use of hormone replacement therapy and treatment for various illnesses.J. Epidemiol. Biostat. 2001; 6: 357-363
- Agreement between interview information and physician records on history of menopausal estrogen use.Am. J. Epidemiol. 1990; 131: 815-825
Article info
Publication history
Accepted:
February 17,
2004
Received in revised form:
January 25,
2004
Received:
August 11,
2003
Identification
Copyright
© 2004 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
