Nelson Richard L, Turyk Mary, Kim Jane, Persky Victoria
Department of Surgery, University of Illinois at Chicago, USA.
BMC Cancer. 2002 Sep 12;2(1):22. doi: 10.1186/1471-2407-2-22.
Bone mineral density (BMD) is a marker of long-term estrogen exposure. BMD measurement has been used in this context to investigate the association of estrogen with breast cancer risk in three cohorts. In order to assess further BMD as a predictor of estrogen related cancer risk, the association of BMD with colorectal and corpus uteri cancer was investigated in the NHANES I Epidemiologic Followup Study (NHEFS) cohort along with breast cancer and prostate cancer.
Participants were members of the NHEFS cohort who had BMD measurement in 1974-1975. Age, race, and BMI adjusted rate ratios and 95% confidence intervals were calculated for incidence of cancers of the corpus uterus, breast, colorectum, prostate, and of osteoporosis and hip fracture related to baseline BMD.
Data were available for 6046 individuals. One hundred cases of breast cancer, 94 prostate cancers, 115 colorectal cancers, 29 uterine cancers, 110 cases of hip fracture and 103 cases of osteoporosis were reported between 1974 and 1993. Hip fracture and osteoporosis were both significantly inversely associated with BMD. Uterine cancer was positively associated (p = 0.005, test for linear trend) and colorectal cancer negatively associated (p = 0.03) with BMD. No association was found between elevated BMD and incidence of breast cancer (p = 0.74) or prostate cancer (p = 0.37) in the overall cohort, although a weak association was seen between BMD and subsequent breast cancer incidence when BMD was measured in post-menopausal women (p = 0.04).
The findings related to cancers of the uterus and colorectum as well as the weak association of BMD with breast cancer strengthen the use of BMD as a marker of estrogen exposure and cancer risk.
骨矿物质密度（BMD）是长期雌激素暴露的一个标志物。在三个队列研究中，BMD测量已被用于研究雌激素与乳腺癌风险之间的关联。为了进一步评估BMD作为雌激素相关癌症风险的预测指标，在国家健康和营养检查调查I流行病学随访研究（NHEFS）队列中，研究了BMD与结直肠癌、子宫体癌以及乳腺癌和前列腺癌之间的关联。
参与者为NHEFS队列中在1974 - 1975年进行了BMD测量的成员。计算了年龄、种族和体重指数调整后的子宫体癌、乳腺癌、结直肠癌、前列腺癌以及与基线BMD相关的骨质疏松症和髋部骨折发病率的比率及95%置信区间。
有6046人的数据可用。在1974年至1993年期间，报告了100例乳腺癌、94例前列腺癌、115例结直肠癌、29例子宫癌、110例髋部骨折和103例骨质疏松症病例。髋部骨折和骨质疏松症均与BMD显著负相关。子宫癌与BMD呈正相关（p = 0.005，线性趋势检验），结直肠癌与BMD呈负相关（p = 0.03）。在整个队列中，未发现BMD升高与乳腺癌发病率（p = 0.74）或前列腺癌发病率（p = 0.37）之间存在关联，尽管在绝经后妇女中测量BMD时，BMD与随后的乳腺癌发病率之间存在微弱关联（p = 0.04）。
与子宫癌和结直肠癌相关的研究结果以及BMD与乳腺癌之间的微弱关联，强化了将BMD用作雌激素暴露和癌症风险标志物的用途。
