McGlynn Katherine A, Gridley Gloria, Mellemkjaer Lene, Brinton Louise A, Anderson Kenneth C, Caporaso Neil E, Landgren Ola, Olsen Jorgen H
Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, EPS-Suite 550, 6120 Executive Boulevard, Rockville, MD 20852-7234, USA.
Int J Cancer. 2008 Apr 15;122(8):1879-84. doi: 10.1002/ijc.23290.
Low hormone levels among persons with osteoporosis may decrease risk of some cancers. Other osteoporosis risk factors, such as smoking and alcohol consumption, however, may increase risk. As these deleterious factors are more often associated with osteoporosis diagnosed prior to age 70 years, cancer risk may be higher in these younger persons than in the general population. To examine this hypothesis, a cohort study of 23,935 persons with osteoporosis was conducted in Denmark. Patients hospitalized with osteoporosis between 1978 and 1993 were identified in the Danish Inpatient Register. Linkage to the Danish Cancer Registry identified all cancer outcomes through 2003. Standardized incidence ratios (SIR) and 95% confidence intervals (95%CI) were calculated to compare cancer incidence in the cohort with that in the general population. Persons diagnosed prior to age 70 years were at increased cancer risk (women: SIR = 1.11, 95%CI = 1.04-1.19; men: SIR = 1.31, 95%CI = 1.13-1.50) due, in part, to increased risks of cancers of the buccal cavity, esophagus, liver, pancreas and lung. Persons diagnosed at ages 70 and older were at decreased risk (women: SIR = 0.91, 95%CI = 0.87-0.96; men: SIR = 0.89, 0.77-1.01) due, in part, to decreased risks of breast, endometrial, colon, rectal and brain cancers in women and prostate cancer in men. These results suggest that risk factors associated with earlier onset osteoporosis may be associated with increased risk of cancer. Conversely, factors associated with later onset osteoporosis may be related to a decreased risk of cancer.
骨质疏松症患者体内激素水平较低可能会降低某些癌症的风险。然而，其他骨质疏松症风险因素，如吸烟和饮酒，可能会增加患癌风险。由于这些有害因素更常与70岁之前诊断出的骨质疏松症相关，因此这些较年轻患者的癌症风险可能高于一般人群。为了验证这一假设，丹麦对23935名骨质疏松症患者进行了一项队列研究。在丹麦住院患者登记册中确定了1978年至1993年间因骨质疏松症住院的患者。与丹麦癌症登记册建立联系后，确定了截至2003年的所有癌症结局。计算标准化发病率（SIR）和95%置信区间（95%CI），以比较该队列中的癌症发病率与一般人群的发病率。70岁之前被诊断出的患者患癌风险增加（女性：SIR = 1.11，95%CI = 1.04 - 1.19；男性：SIR = 1.31，95%CI = 1.13 - 1.50），部分原因是口腔、食管、肝脏、胰腺和肺癌的风险增加。70岁及以上被诊断出的患者患癌风险降低（女性：SIR = 0.91，95%CI = 0.87 - 0.96；男性：SIR = 0.89，0.77 - 1.01），部分原因是女性乳腺癌、子宫内膜癌、结肠癌、直肠癌和脑癌以及男性前列腺癌的风险降低。这些结果表明，与较早发病的骨质疏松症相关的风险因素可能与患癌风险增加有关。相反，与较晚发病的骨质疏松症相关的因素可能与患癌风险降低有关。
