Melin A, Sparén P, Bergqvist A
Department of Obstetrics and Gynaecology, Karolinska University Hospital, Huddinge, K57, Stockholm, Sweden.
Hum Reprod. 2007 Nov;22(11):3021-6. doi: 10.1093/humrep/dem209. Epub 2007 Sep 13.
Several epidemiological studies have shown an increased cancer risk among women with endometriosis, especially ovarian cancer. Infertility and nulliparity are also known risk factors for different types of cancer. The aim of this study is to investigate cancer risk among women with endometriosis, stratifying for parity.
Women discharged from a hospital, with the diagnosis of endometriosis from 1969 to 2002, were identified using the National Swedish Inpatient Register. Data were linked to the National Swedish Cancer Register to identify cases of cancer and to the Swedish Multi-Generation Register to calculate parity and age at first birth. Standardized incidence ratios (SIR) were calculated.
A total of 63,630 women entered the study. To exclude cancers already present at the time of endometriosis diagnosis, the first year of follow-up was excluded, leaving a number of 3,822 cases of cancer. There was no increased overall risk of cancer (SIR 1.01) among women with endometriosis. Endometriosis was associated with elevated risks for endocrine tumours (SIR 1.38), ovarian cancer (SIR 1.37), renal cancer (SIR 1.36), thyroid cancer (SIR 1.33), brain tumours (SIR 1.27), malignant melanoma (SIR 1.23) and breast cancer (SIR 1.08), as well as a reduced risk for cervical cancer (SIR 0.71). There were no significant differences between nulliparous and parous women with endometriosis regarding cancer risk for any of the cancer types. There was a non-significant decrease in risk of ovarian cancer with increasing parity for women with endometriosis.
Women with endometriosis have an increased risk for several malignancies. The increased risks do not seem to be related to parity.
多项流行病学研究表明，患有子宫内膜异位症的女性患癌风险增加，尤其是卵巢癌。不孕和未生育也是不同类型癌症的已知风险因素。本研究的目的是调查患有子宫内膜异位症的女性的患癌风险，并按生育情况进行分层。
利用瑞典国家住院患者登记册确定了1969年至2002年期间出院且诊断为子宫内膜异位症的女性。数据与瑞典国家癌症登记册相链接以确定癌症病例，并与瑞典多代登记册相链接以计算首次生育时的生育情况和年龄。计算标准化发病比（SIR）。
共有63630名女性进入研究。为排除在子宫内膜异位症诊断时已存在的癌症，排除了随访的第一年，剩余3822例癌症病例。患有子宫内膜异位症的女性总体患癌风险没有增加（SIR为1.01）。子宫内膜异位症与内分泌肿瘤（SIR为1.38）、卵巢癌（SIR为1.37）、肾癌（SIR为1.36）、甲状腺癌（SIR为1.33）、脑肿瘤（SIR为1.27）、恶性黑色素瘤（SIR为1.23）和乳腺癌（SIR为1.08）的风险升高相关，以及与宫颈癌风险降低（SIR为0.71）相关。患有子宫内膜异位症的未生育女性和已生育女性在任何癌症类型的患癌风险方面没有显著差异。患有子宫内膜异位症的女性，随着生育次数增加，卵巢癌风险有不显著的降低。
患有子宫内膜异位症的女性患几种恶性肿瘤的风险增加。风险增加似乎与生育情况无关。
