Lamont Elizabeth B, Lauderdale Diane S
Department of Medicine, The University of Chicago, Chicago, IL, USA.
Ann Epidemiol. 2003 Nov;13(10):698-703. doi: 10.1016/s1047-2797(03)00056-5.
Prior research has shown that women with either osteoporotic fracture or low bone density are at a decreased risk of breast cancer. Little prior work has evaluated whether women with breast cancer are at a decreased risk of osteoporotic fracture.
We used data from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER)-Medicare program to study the risk of hip fracture among elderly female Medicare beneficiaries with and without histories of breast cancer. Using the SEER file, we identified elderly women survivors of stage 0, I, or II breast cancer (N=5980) diagnosed between the ages of 55 and 64 years; using the Medicare 5% file, we identified elderly women without histories of cancer (N=23,165) from SEER regions. Using Medicare claims from 1993 through 1998, we followed women for hospitalization for hip fracture or death until December 31, 1998.
We found the rate ratio of hospitalization for hip fracture for breast cancer survivors relative to comparison patients was 0.63 (95% CI: 0.43-0.94) after adjusting for age, race, socioeconomic status, geographic location, cohort entry year, and medical comorbidity.
We conclude that survivors of early stage post-menopausal breast cancer are at significantly lower risk of hip fracture than women who do not have histories of breast cancer.
先前的研究表明，患有骨质疏松性骨折或骨密度低的女性患乳腺癌的风险降低。此前很少有研究评估患乳腺癌的女性发生骨质疏松性骨折的风险是否降低。
我们使用了美国国立癌症研究所的监测、流行病学和最终结果（SEER）-医疗保险计划的数据，来研究有和没有乳腺癌病史的老年女性医疗保险受益人中髋部骨折的风险。利用SEER文件，我们确定了年龄在55至64岁之间被诊断为0期、I期或II期乳腺癌的老年女性幸存者（N = 5980）；利用医疗保险5%文件，我们从SEER地区确定了没有癌症病史的老年女性（N = 23165）。利用1993年至1998年的医疗保险理赔记录，我们对这些女性进行随访，观察其因髋部骨折住院或死亡情况，直至1998年12月31日。
在调整了年龄、种族、社会经济地位、地理位置、队列进入年份和合并症后，我们发现乳腺癌幸存者髋部骨折住院率与对照患者相比的率比为0.63（95%可信区间：0.43 - 0.94）。
我们得出结论，绝经后早期乳腺癌幸存者发生髋部骨折的风险明显低于没有乳腺癌病史的女性。
