Abstract PS7-05: Estrogen-based hormone replacement therapy [E-HRT] reduces all-cause, breast cancer, and Alzheimer's dementia mortality
Bibliographic record
Abstract
Abstract OBJECTIVES. To evaluate the long-term population-level impact of E-HRT on cause-specific and all-cause mortality in postmenopausal women in the USA, using the results of the 2017 Women’s Health Initiative HRT Trial 2 update.1 Of particular interest was the significantly reduced Breast Cancer [BrCa] mortality rates [RR=0.55, 95% C.I.=0.33-0.92].1 METHODOLOGY. In the WHI HRT Trial 2, women were randomized to receive estrogen (E) or placebo (P).1 For our analyses, the Annualized mortality rates (AR) were extracted for women aged 50-59, 60-69, 70-79, for breast cancer, Alzheimer's dementia, and all-cause mortality. The Median follow-up was 18 years. The Annualized Mortality Rate Difference (ARD) between the two groups was calculated as a difference of the AR between the P vs. E (AR in P - [minus] AR in E), expressed per 100,000 person-years. Subsequently, the Number of Avoided Deaths per year (NAD/year) was calculated using the number of women in each age group from the 2010 US census data. RESULTS. The annualized number of deaths avoided by the use of E-HRT in the US population was estimated as follows: BrCa, 9,292; Alzheimer’s dementia: 18,966; and all cause-mortality: 50,008 (Table). CONCLUSIONS. These data show a major beneficial impact of E-HRT, with over 50,000 deaths/year prevented in the USA alone. While these gains, sustained throughout the follow-up, represent undoubtedly major multi-organ metabolic benefits of estrogen, the most striking and unexpected findings involve BrCa, with over 9,000 BrCa deaths potentially avoided each year, just in the USA alone. RECOMMENDATION. Adoption and implementation of E-based HRT to the current HRT medical guidelines, to extend the health benefits to millions of women, and to prevent thousands of deaths each year in the USA alone. REFERENCE.1.Manson JE et al. Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women’s Health Initiative Randomized Trials. J Am Med Assoc 2017; 318(10): 927-938. AgesAge 50 – 59(N=21,506,008)Age 60 – 69(N=15,323,140)Age 70 – 79(N=9,169,601)ALL ages(N=45,998,749)ARD / 100,000NAD / YearARD / 100,000NAD / YearARD / 100,000NAD / YearNAD / YearBreast Cancer204,301233,524161,4679,292Alzheimer’s Dementia00406,12914012,83718,966All-Cause Mortality15032,259507,66211010,08750,008 Citation Format: Joseph Ragaz, Shayan Shakeraneh, Hong Qian, Hubert Wong, John J. Spinelli, Kenneth S. Wilson. Estrogen-based hormone replacement therapy [E-HRT] reduces all-cause, breast cancer, and Alzheimer's dementia mortality [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-05.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".