Objective: To determine whether transdermal hormone therapy produces less effects on the development of gallbladder disease and cancer than oral hormone therapy. Data sources: OVID, PubMed, Medline, and NIH Study selection: Studies that included women who are 40 -75 years of age who were naive to hormone therapy. Studies chosen had to include both transdermal and oral routes of hormone administration as well as findings related to gallbladder disease, cancer, or markers that affect these conditions. Reviews were not included in our study criteria. The primary outcome was incidence of gallbladder disease and cholecystectomy. Data synthesis: Of the 98 articles, 5 articles were included in the assessment. 2 studies assessed gallbladder disease/cholecystectomy, 2 assessed biomarkers for gallbladder stone, and 1 assessed gallbladder disease as a risk for gallbladder cancer. Prospective data suggests that transdermal hormone therapy has a lower risk of gallbladder disease and cholecystectomy. Evidence also suggests a positive correlation between gallbladder disease and gallbladder cancer. Conclusions: The preliminary evidence suggests that transdermal hormone therapy has a lower risk of gallbladder cancer. There is a strong association between gallbladder cancer and cholelithiasis, chronic cholecystitis, and inflammation. Based on the evidence, transdermal therapy may have a lower risk of gallbladder disease and cholecystectomy. In addition, transdermal has a more favorable lipid panel. The evidence also suggests some correlation between hypercholesterolemia and risk of cholecystectomy.
Hersi, Faid; Onwonga, Esther B.; Horst, Jenna.
Comparing the effects of transdermal hormone therapy to oral hormone therapy on gallbladder disease, cholecystectomy, and gallbladder cancer.
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