Certified in Public Health (CPH) Practice Exam

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What conclusion can be drawn from studies comparing mortality rates due to cancer of the uterus in estrogen users versus non-users?

The mortality rates are equal in both groups.
The mortality rates for cancer of the uterus are higher in estrogen users than non-users in both age groups studied.
Non-users have a higher incidence of uterine cancer than users.
The existence of a causal relationship is proven between estrogen use and uterine cancer.

The correct answer is: The mortality rates for cancer of the uterus are higher in estrogen users than non-users in both age groups studied.

The conclusion that mortality rates for cancer of the uterus are higher in estrogen users than non-users in both age groups studied is supported by research findings indicating a potential link between estrogen use and increased risk of developing certain cancers, particularly uterine cancer. Estrogen, when used in hormone replacement therapy or as a part of contraceptive treatment, may contribute to increased proliferation of the endometrial lining, leading to a higher likelihood of cancerous changes. Research typically indicates that women who have used estrogen without the balancing effect of progesterone (which counteracts the stimulatory effects of estrogen on the endometrium) are at a substantially increased risk for endometrial hyperplasia and subsequently endometrial cancer. Thus, the findings that mortality rates are higher in estrogen users align with the understanding that prolonged exposure to estrogen without adequate progesterone protection increases the risk of a more severe outcome, such as increased mortality. This conclusion underscores the importance of considering hormone usage in understanding cancer epidemiology, emphasizing the need for careful medical management when prescribing estrogen-containing therapies. It reflects the broader understanding of cancer risk factors related to hormone use and contributes to ongoing discussions in public health about treatment strategies and cancer prevention measures.