Could the health and well-being of a few million women be improved, and a few billion dollars saved in the process? A very big dream.
When the Women's Health Initiative was established more than 20 years ago, no one was talking in grandiose terms and few would have anticipated the wide-ranging health benefits (and huge cost savings) that would result in the decades ahead. Many of us were simply saying, "Imagine this. At last we're studying women to find answers about women's health issues."
This writer was proud and happy to enlist in the first WHI study. I joined more than 100,000 other postmenopausal women volunteering to fill out forms, have blood drawn and answer questions over the next 15 years. That initial focus was on tracking the effects of hormone therapy, dietary patterns and/or calcium/vitamin D supplements on prevention of heart disease, cancer and osteoporotic fractures. I had not yet had breast cancer -- that would come about 10 years into the study; a family history of osteoporosis added to my personal interest in WHI. Over the years I volunteered to participate in some of the wide-ranging ancillary studies looking at other health-related things like physical activities, lifestyle, tobacco and dozens of peripheral issues. (My personal favorite question appeared on one of the multi-page annual update forms. It read -- Yes or No -- "When you enter a room full of other people, do you have the feeling they are talking about you?" There may someday be a report on women and paranoia.)
Mysterious questions aside, WHI is serious business. Here, excerpted from the latest Extension Study newsletter are a few facts about what has been learned from the historic initiative, and a little of what is still ahead.
Those hormones millions of postmenopausal women were taking, widely thought to be miracle answers? Studies showed the risks far outweighed the benefits, and millions stopped taking them. Hormones in different combinations had been commonly taken to minimize chances of cardiovascular disease, cancers, fractures, diabetes, gall bladder disease and a variety of quality-of-life measures; quitting the hormones proved a better choice. Health benefits can't be precisely measured, but the reduction in hormone use has led to a decrease in rates of breast cancer and cardiovascular disease.
And in dollars and cents? Some $37.1 billion, (in 2012) when all costs and quality-adjusted years of life are considered, has been the total economic return of the WHI trial.
By June 2014, over 1000 papers based on WHI data had been published in scientific journals. What's ahead? Researchers are looking at pet ownership and risk of cardiovascular disease; physical activity during childhood and risk of Alzheimer's disease; breast cancer distribution by rural/urban areas and geographic differences in cognitive decline/dementia.
Every year on their birthday, WHI study participants receive a card -- some of us call it the "Hooray, you're still alive" card. For women everywhere, it represents something worth more than gold.