Csizmadi I, Collet J-P, Benedetti A, Boivin J-F, Hanley J A
Centre for Clinical Epidemiology, S.M.B.D. Jewish General Hospital, 3755 Chemin de la Côte Ste-Catherine, Montreal, Quebec, Canada.
Br J Cancer. 2004 Jan 12;90(1):76-81. doi: 10.1038/sj.bjc.6601438.
The aim of this study was to examine the effects of oral and transdermal oestrogen replacement therapy on the risk of colorectal cancer. Data from a nested case-control study, designed to investigate the effect of hormone replacement therapy (HRT) on colorectal cancer were analysed. New cases of colorectal cancer, diagnosed between 1992 and mid-1998 (N=1197), were identified using the Saskatchewan Cancer Agency cancer registry. Women >/=50 years of age, eligible for coverage by the Saskatchewan Prescription Drug Plan, were included in the study. Four controls per case were age matched to cases, using incidence density sampling. The outpatient prescription drug plan database was used to ascertain oestrogen prescriptions. Women were classified according to history of transdermal (TDE) and oral (OE) oestrogen use. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Compared with women who had never used HRT, ORs for <3 and >/=3 years of TDE use and colorectal cancer were 0.69 (95% CI: 0.43-1.10) and 0.33 (95% CI: 0.12-0.95), and for OE use were 0.90 (95% CI: 0.73-1.01) and 0.75 (95% CI: 0.60-0.93), respectively. The risk reduction for colorectal cancer with TDE may be greater in magnitude than that which has been reported for oral HRT.
本研究的目的是探讨口服和经皮雌激素替代疗法对结直肠癌风险的影响。对一项旨在研究激素替代疗法(HRT)对结直肠癌影响的巢式病例对照研究的数据进行了分析。利用萨斯喀彻温癌症机构癌症登记处确定了1992年至1998年年中诊断出的1197例结直肠癌新病例。年龄≥50岁、符合萨斯喀彻温省处方药计划覆盖范围的女性被纳入研究。采用发病密度抽样方法,为每个病例匹配4名年龄相仿的对照。利用门诊处方药计划数据库确定雌激素处方情况。根据经皮(TDE)和口服(OE)雌激素使用史对女性进行分类。采用条件逻辑回归来估计比值比(OR)和95%置信区间(CI)。与从未使用过HRT的女性相比,TDE使用<3年和≥3年与结直肠癌的OR分别为0.69(95%CI:0.43 - 1.10)和0.33(95%CI:0.12 - 0.95),OE使用的OR分别为0.90(95%CI:0.73 - 1.01)和0.75(95%CI:0.60 - 0.93)。经皮雌激素对结直肠癌的风险降低幅度可能大于口服HRT所报告的幅度。