Vatten L J, Romundstad P R, Trichopoulos D, Skjaerven R
Department of Community Medicine and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
Br J Cancer. 2002 Oct 21;87(9):971-3. doi: 10.1038/sj.bjc.6600581.
Women who experience pre-eclampsia or hypertension during pregnancy may have a reduced risk for breast cancer later in life. The evidence is based on case-control studies, and here we report the results of a cohort study exploring the link between pre-eclampsia and gestational hypertension diagnosed in the first pregnancy and subsequent risk for breast cancer. We combined information from the Medical Birth Registry and the Cancer Registry in Norway, which are both nation-wide. Between 1967, when the birth registry was established, and 1998, 694 657 women were recorded with a first birth, and classified according to whether pre-eclampsia and/or hypertension was diagnosed in the first pregnancy. Linkage to the Norwegian Cancer Registry identified 5474 new cases of breast cancer diagnosed subsequently to their first delivery. Compared to other parous women, women with pre-eclampsia and/or hypertension diagnosed in their first pregnancy had 19% lower risk (95% confidence interval, 9 to 29%) for breast cancer, after adjustment for attained age, calendar period of diagnosis, age at first birth, and parity. This result was similar for term and preterm deliveries, across the range of offspring birth weight, and for pre- and postmenopausal women. These results suggest that the pathophysiology surrounding pre-eclampsia and gestational hypertension plays an important role in breast cancer etiology. A better understanding of the underlying processes could provide an insight into the pathogenesis of breast cancer.
孕期出现先兆子痫或高血压的女性日后患乳腺癌的风险可能会降低。证据基于病例对照研究,在此我们报告一项队列研究的结果,该研究探讨首次怀孕时诊断出的先兆子痫和妊娠高血压与后续患乳腺癌风险之间的联系。我们整合了挪威全国范围的医疗出生登记处和癌症登记处的信息。在1967年(出生登记处设立之年)至1998年期间,记录了694657名首次生育的女性,并根据首次怀孕时是否诊断出先兆子痫和/或高血压进行分类。与挪威癌症登记处的关联确定了5474例首次分娩后诊断出的乳腺癌新病例。在对年龄、诊断的日历时间、初产年龄和产次进行调整后,与其他经产妇相比,首次怀孕时诊断出先兆子痫和/或高血压的女性患乳腺癌的风险降低了19%(95%置信区间为9%至29%)。对于足月和早产分娩、不同范围的子代出生体重以及绝经前和绝经后女性,这一结果都是相似的。这些结果表明,围绕先兆子痫和妊娠高血压的病理生理学在乳腺癌病因学中起着重要作用。更好地理解潜在过程可能有助于深入了解乳腺癌的发病机制。