Evaluation of the real-world use of hormone replacement therapy (HRT) in women with neuroendocrine cancers in sheffield teaching hospitals european neuroendocrine tumour centre of excellence

Gamage Kavinga Kobawaka; Kashish Kapoor; Sara Fiaz; Alia Munir

doi:10.1530/endoabs.114.P12

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Endocrine Abstracts (2025) 114 P12 | DOI: 10.1530/endoabs.114.P12

UKINETS2025 23rd National Conference of the UK and Ireland Neuroendocrine Tumour Society 2025 Poster Presentations (33 abstracts)

Evaluation of the real-world use of hormone replacement therapy (HRT) in women with neuroendocrine cancers in sheffield teaching hospitals european neuroendocrine tumour centre of excellence

Kavinga Kobawaka Gamage ¹ , Kashish Kapoor ² , Sara Fiaz ² & Alia Munir ¹

Author affiliations

¹Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, United Kingdom; ²University of Sheffield, Sheffield, United Kingdom

Introduction: In 2023, Gov.UK reported that around 15% of women aged 45-64 were prescribed HRT. The use of HRT in women with neuroendocrine tumors (NETs) remains uncertain, due to limited data available. Here we evaluated the use of HRT in women with NETs in the perimenopausal and menopausal age and to assess its association with tumour grade, stage and biomarkers.

Methodology: A retrospective review of the Sheffield NET database was performed on women aged 40-64 diagnosed with NETs, with ongoing follow-up in 2025. Data included demographics, tumor site, stage, grade, biomarker levels (chromogranin A, 5-HIAA), HRT prescriptions, and prescribers. Data analysis was conducted using SPSS.

Results: A total of 190 women aged 40-65 (mean age 56.5) were identified. The most common neuroendocrine tumor (NET) subtype was small bowel NET (27.4%), followed by pancreatic NET (26.3%) and appendiceal NET (12.6%). Of these, 42.9% (n = 76) were stage 1, and 28.2% (n = 50) were stage 4. Over half of the stage 4 cases (56%, n = 28) involved small bowel NETs, while pulmonary NETs accounted for most stage 1 cases (22.4%). Regarding grading, 67.7% (n = 109) had Grade 1 disease, with the pancreas as the primary site in 23.8% (n = 26). Overall, 36 (19%) patients were on HRT, mainly transdermal estrogen (75%) and vaginal estrogen (22.2%). Only 7.7% of small bowel NET patients received HRT, despite being the most common subgroup. No significant correlation was found between HRT use and disease stage (P = 0.49), grade, or biomarkers chromogranin A and 5-HIAA (P = 0.24 and P = 0.69).

Conclusion: Compared to the general population, HRT use was higher in women with NET in our cohort. The grade and the stage did not correlate with HRT prescription. This may be due to the perceived as having symptom overlap of Carcinoid syndrome and vasomotor symptoms. However, these results were limited due to small sample size. This highlights the need to implement further studies on HRT prescription in women with NET, which would further assist in developing guidance on HRT use in this complex population.