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BMJ 2006; 333 doi: (Published 29 June 2006) Cite this as: BMJ 2006;333:37
  1. Alison Tonks (, associate editor

    Raloxifene prevents breast cancer as effectively as tamoxifen

    Raloxifene is widely used in primary care to prevent and treat osteoporosis in postmenopausal women. Raloxifene can also protect women from breast cancer, and worked as well as tamoxifen in a large trial.

    Credit: JAMA

    Nearly 20 000 postmenopausal women with a high risk of breast cancer—mostly with a family history—took raloxifene or tamoxifen for a mean of four years. About the same proportion in each group developed invasive breast cancer (4.3 per 1000 and 4.41 per 1000 respectively; risk ratio 1.02 (95% CI 0.82 to 1.28)), although the researchers found a trend towards fewer non-invasive cancers among women taking tamoxifen. Raloxifene was associated with slightly fewer thromboembolic events and cataracts.

    The researchers were hoping that raloxifene would be kinder on the endometrium than tamoxifen, and they did find a substantially lower incidence of endometrial hyperplasia among women taking raloxifene (0.16; 0.09 to 0.29). But the hoped for reduction in uterine cancers failed to reach statistical significance (0.62; 0.35 to 1.08 for women taking raloxifene).

    Women and their doctors have been slow to accept the idea of chemoprevention of breast cancer—possibly because they see tamoxifen as cancer chemotherapy. Raloxifene looks like an effective but more familiar alternative. More than half a million American women are already taking it.

    Male condoms protect women from human papillomaviruses

    Researchers studying whether condoms protect women against human papillomavirus infection had to mail more than 24 000 letters to find 150 young women who had not yet had sex (or had had their first sex less than two weeks before). Their sample size got even smaller after excluding the 65 women who did not have sex during the study period either. The researchers finally managed to analyse data from 82 women who had their first sexual encounter during the study. The women kept fortnightly diaries of their sexual activities and were screened …

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