Norsa'adah B, Rusli B N, Imran A K, Naing I, Winn T
Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Malaysia.
Singapore Med J. 2005 Dec;46(12):698-705.
Breast cancer is the commonest cancer for females in Malaysia, with a prevalence of 86.2 per 100,000 women in 1996. Breast cancer mortality rate shows an increasing trend in Malaysia from 0.61 in 1983 to 1.8 per 100,000 women in 1992. The aim of this study was to identify the risk factors for breast cancer in women in Malaysia.
A matched case-control study was carried out at referral hospitals in Kelantan from July 2000 to June 2001. A standardised questionnaire that comprised socio-demographical factors, obstetrical and gynaecological histories, anthropometric measurements, and other potential risk factors for breast cancer, was used to interview 147 histologically-confirmed breast cancer patients and 147 controls. Controls were non-breast cancer patients who were matched for age and ethnicity, and excluded those with malignancies, or having gynaecological, hormonal or endocrine problems. Simple and multiple conditional logistic regressions were used for analyses.
Factors contributing toward increased risk of breast cancer were nulliparity (odds ratio [OR] of 15.3; 95 percent confidence interval [CI] of 3.2, 72.4), overweight (OR of 2.1; 95 percent CI of 1.1, 3.9), family history of breast cancer (OR of 4.3; 95 percent CI of 1.3, 14.1) and previous use of oral contraceptives (OR of 2.5; 95 percent CI of 1.3, 4.8).
This study reconfirmed that similar risk factors identified in Western populations were responsible for the occurrence of breast cancer in Kelantan. It also supported the theory that breast cancer occurrence was related to oestrogen exposure and familial factors. It suggested the importance of having children, maintaining ideal body weight and caution for oral contraceptive users and women with a family history of breast cancer.
乳腺癌是马来西亚女性中最常见的癌症，1996年每10万名女性中的患病率为86.2。马来西亚的乳腺癌死亡率呈上升趋势，从1983年的每10万名女性中有0.61例升至1992年的每10万名女性中有1.8例。本研究的目的是确定马来西亚女性患乳腺癌的风险因素。
2000年7月至2001年6月在吉兰丹的转诊医院开展了一项配对病例对照研究。使用一份标准化问卷对147例经组织学确诊的乳腺癌患者和147名对照进行访谈，问卷内容包括社会人口统计学因素、妇产科病史、人体测量数据以及其他乳腺癌潜在风险因素。对照为年龄和种族匹配的非乳腺癌患者，排除患有恶性肿瘤或有妇科、激素或内分泌问题的患者。采用简单和多重条件逻辑回归进行分析。
导致乳腺癌风险增加的因素有未生育（比值比[OR]为15.3；95%置信区间[CI]为3.2, 72.4）、超重（OR为2.1；95%CI为1.1, 3.9）、乳腺癌家族史（OR为4.3；95%CI为1.3, 14.1）以及既往使用口服避孕药（OR为2.5；95%CI为1.3, 4.8）。
本研究再次证实，在西方人群中发现的类似风险因素导致了吉兰丹乳腺癌的发生。它还支持了乳腺癌的发生与雌激素暴露和家族因素有关的理论。这表明生育、保持理想体重的重要性，以及对口服避孕药使用者和有乳腺癌家族史的女性的警示意义。
