Katalinic Alexander, Rawal Rajesh
Institute of Cancer Epidemiology, University of Lübeck, Beckergrube 43-47, 23552, Lubeck, Germany.
Breast Cancer Res Treat. 2008 Feb;107(3):427-30. doi: 10.1007/s10549-007-9566-z. Epub 2007 Apr 24.
Hormone replacement therapy (HRT) has been implicated as a risk factor for breast cancer and the use of HRT has decreased substantially in general population over the last years. Recently, there are first indications that breast cancer incidence has started declining. We examined recent breast cancer incidence and actual data on HRT utilisation in Schleswig-Holstein, Germany, to find out population based evidence on decreasing breast cancer incidence and its possible relationship with reduced HRT usage. Breast cancer incidence is taken from the population based cancer registry of Schleswig-Holstein. HRT data was extracted from a cohort of 102,000 women taking part in a quality assurance project in breast cancer diagnosis for the years 2001-2005. The annual percentage change in incidence of breast cancer and HRT utilisation was measured by linear regression. There is a linear decline in HRT utilisation among less than 50 years group, 50-69 years group and all age group women between the years 2001 and 2005. Breast cancer incidence decreased between the years 2001 and 2005 for more than 50 years old and all age group, but not in the younger than 50 years women. The decline of breast cancer incidence started about two years after the HRT decline. Breast cancer incidence decline and decreased HRT utilisation showed a high correlation. A drastic change in age-incidence relationship in breast cancer has taken place, the change is likely to continue and in future it has to be monitored closely with HRT use and other possible explanations.
激素替代疗法（HRT）被认为是乳腺癌的一个风险因素，在过去几年中，普通人群中HRT的使用已大幅减少。最近，有初步迹象表明乳腺癌发病率已开始下降。我们研究了德国石勒苏益格-荷尔斯泰因州近期的乳腺癌发病率以及HRT使用的实际数据，以找出基于人群的证据，证明乳腺癌发病率下降及其与HRT使用减少之间可能存在的关系。乳腺癌发病率数据取自石勒苏益格-荷尔斯泰因州基于人群的癌症登记处。HRT数据是从2001年至2005年参与乳腺癌诊断质量保证项目的102,000名女性队列中提取的。通过线性回归测量乳腺癌发病率和HRT使用的年度百分比变化。在2001年至2005年期间，年龄小于50岁组、50 - 69岁组以及所有年龄组女性的HRT使用呈线性下降。2001年至2005年期间，50岁以上及所有年龄组的乳腺癌发病率下降，但小于50岁女性的发病率未下降。乳腺癌发病率的下降大约在HRT下降两年后开始。乳腺癌发病率下降与HRT使用减少显示出高度相关性。乳腺癌年龄发病率关系发生了剧烈变化，这种变化可能会持续，未来必须密切监测HRT使用情况以及其他可能的解释。
