Negri E, Tzonou A, Beral V, Lagiou P, Trichopoulos D, Parazzini F, Franceschi S, Booth M, La Vecchia C
Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Int J Cancer. 1999 Mar 15;80(6):848-51. doi: 10.1002/(sici)1097-0215(19990315)80:6<848::aid-ijc8>3.0.co;2-e.
The relationship between hormonal therapy for menopause (hormone replacement therapy, HRT) and the risk of epithelial ovarian cancer was evaluated in a collaborative re-analysis of 4 European case-control studies, 2 conducted in Greece and 1 each in Italy and the United Kingdom, including a total of 1,470 ovarian cancer cases and 3,271 hospital controls. Odds ratios (ORs) for HRT use were derived after allowance for study centre, age, socio-economic level, parity, menopausal status, type of menopause, age at menopause and oral contraceptive use. Overall, 109 (8.0%) ovarian cancer cases and 146 (4.7%) controls had ever used HRT, corresponding to an adjusted OR of 1.71 (95% confidence interval 1.30-2.25). The point estimates of the OR were 1.77 in the first Greek study, 1.40 in the second Greek study, 1.66 in the Italian study and 1.68 in the British study. Adjustment for possible confounders, including menopausal status, type of menopause, age at menopause and oral contraceptive use, slightly increased the OR. Limiting the analysis to women with information on relevant aspects of HRT use revealed a weak positive association with duration and some evidence that the excess relative risk for ovarian cancer declined with time since last use. These findings are compatible with a promoting effect of HRT in ovarian carcinogenesis. It is also possible, however, that the positive association reflects chance or selective administration of HRT to high-risk individuals, since until recently in Europe HRT was prescribed mainly for alleviation of peri-menopausal symptoms.
在对4项欧洲病例对照研究进行的一项合作重新分析中，评估了更年期激素治疗（激素替代疗法，HRT）与上皮性卵巢癌风险之间的关系。其中2项研究在希腊进行，1项在意大利进行，1项在英国进行，总共纳入了1470例卵巢癌病例和3271例医院对照。在考虑研究中心、年龄、社会经济水平、产次、绝经状态、绝经类型、绝经年龄和口服避孕药使用情况后，得出了使用HRT的比值比（OR）。总体而言，109例（8.0%）卵巢癌病例和146例（4.7%）对照曾使用过HRT，对应的调整后OR为1.71（95%置信区间1.30 - 2.25）。在第一项希腊研究中，OR的点估计值为1.77，第二项希腊研究中为1.40，意大利研究中为1.66，英国研究中为1.68。对包括绝经状态、绝经类型、绝经年龄和口服避孕药使用情况等可能的混杂因素进行调整后，OR略有增加。将分析局限于具有HRT使用相关方面信息的女性，发现与使用持续时间呈弱正相关，并且有一些证据表明，自上次使用HRT以来，卵巢癌的超额相对风险随时间下降。这些发现与HRT在卵巢癌发生过程中的促进作用相符。然而，也有可能这种正相关反映的是偶然性，或者是对高危个体选择性使用HRT，因为直到最近在欧洲，HRT主要是为缓解围绝经期症状而开具的。
