Schildkraut J M, Cooper G S, Halabi S, Calingaert B, Hartge P, Whittemore A S
Program for Prevention, Detection, and Control Research, Duke Comprehensive Cancer Center, Durham, North Carolina 27710, USA.
Obstet Gynecol. 2001 Jul;98(1):85-90. doi: 10.1016/s0029-7844(01)01388-6.
To investigate the relationship between age at natural menopause and risk of developing epithelial ovarian cancer.
Using data from six population-based, case-control studies conducted in the United States, age at natural menopause among 1411 women with epithelial ovarian cancer and 6380 control subjects were analyzed using survival analysis methods, including Kaplan-Meier and proportional hazards models. Subjects ranged from 20 to 81 years of age.
The median age at natural menopause was 50 years among cases compared with 51 years among controls, a difference of borderline statistical significance (P =.06). The hazard ratio for the relationship between case-control status and age at natural menopause was 1.09 (95% confidence interval 0.99, 1.20). Controlling for potential confounders including parity, oral contraceptive use, tubal ligation, smoking, and body mass index did not appreciably change this association. There was little evidence of an association between early age at natural menopause and early onset ovarian cancer (diagnosis age under 48 years).
We observed a weak association between ovarian cancer risk and age at natural menopause and, among women with early onset disease, there was little evidence to suggest that early menopause is related to ovarian cancer. Thus, there seems little need for increased surveillance or screening for ovarian cancer among women with early natural menopause.
探讨自然绝经年龄与上皮性卵巢癌发病风险之间的关系。
利用在美国开展的六项基于人群的病例对照研究数据,采用生存分析方法(包括Kaplan-Meier法和比例风险模型)对1411例上皮性卵巢癌女性患者及6380例对照者的自然绝经年龄进行分析。研究对象年龄范围为20至81岁。
病例组自然绝经年龄中位数为50岁,对照组为51岁,差异具有临界统计学意义(P = 0.06)。病例对照状态与自然绝经年龄之间关系的风险比为1.09(95%置信区间0.99, 1.20)。对包括产次、口服避孕药使用情况、输卵管结扎、吸烟及体重指数等潜在混杂因素进行控制后,该关联无明显变化。几乎没有证据表明自然绝经年龄早与卵巢癌早发(诊断年龄小于48岁)之间存在关联。
我们观察到卵巢癌风险与自然绝经年龄之间存在微弱关联,且在早发疾病的女性中,几乎没有证据表明早绝经与卵巢癌有关。因此,对于自然绝经早的女性,似乎没有必要增加卵巢癌监测或筛查。