Kmet Leanne M, Cook Linda S, Weiss Noel S, Schwartz Stephen M, White Emily
Department of Community Health Sciences, University of Calgary, Alta., Canada.
Breast Cancer Res Treat. 2003 May;79(2):143-7. doi: 10.1023/a:1023926401227.
To investigate risk factors for colorectal cancer following breast cancer.
In this nested case-control study, all women (n = 14,900) with a first primary breast cancer (1978-1992) were identified from the western Washington population-based Surveillance, Epidemiology, and End Results Cancer Registry. Cases (n = 160) developed a second primary colorectal cancer before 1995, at least 6 months after the first cancer diagnosis. Controls (n = 310, matched to the cases on calendar year, age and breast cancer stage) were randomly selected from those who did not develop a second primary cancer and who survived to the case's colorectal cancer diagnosis date. Characteristics of the cases and controls at initial diagnosis were compared using conditional logistic regression.
The incidence of colorectal cancer was associated with a family history of breast cancer (v.s. no family history, matched odds ratio (mOR) = 2.1, 95% confidence interval (CI): 1.1-4.1), high body mass index (> or = 30kg/m2 v.s. < 30kg/m2, mOR = 2.2, CI: 1.2-3.9), and lobular breast cancer histology (v.s. ductal, mOR = 2.0, CI: 0.9-4.4). Risk was unrelated to menopausal status, prior hormone replacement therapy and estrogen/progesterone receptor status of the breast tumors.
The risk of developing a second primary colorectal cancer may be elevated among certain subsets of breast cancer patients.
探讨乳腺癌患者发生结直肠癌的危险因素。
在这项巢式病例对照研究中，从华盛顿州西部基于人群的监测、流行病学和最终结果癌症登记处识别出所有患有原发性乳腺癌（1978 - 1992年）的女性（n = 14,900）。病例组（n = 160）在1995年前发生了第二原发性结直肠癌，且在首次癌症诊断后至少6个月。对照组（n = 310，按历年、年龄和乳腺癌分期与病例匹配）从未发生第二原发性癌症且存活至病例结直肠癌诊断日期的人群中随机选取。使用条件逻辑回归比较病例组和对照组初次诊断时的特征。
结直肠癌的发病率与乳腺癌家族史（与无家族史相比，匹配比值比（mOR）= 2.1，95%置信区间（CI）：1.1 - 4.1）、高体重指数（≥30kg/m²与<30kg/m²相比，mOR = 2.2，CI：1.2 - 3.9）以及小叶型乳腺癌组织学类型（与导管型相比，mOR = 2.0，CI：0.9 - 4.4）相关。风险与绝经状态、既往激素替代疗法以及乳腺肿瘤的雌激素/孕激素受体状态无关。
某些乳腺癌患者亚组发生第二原发性结直肠癌的风险可能会升高。
