Moorman Patricia G, Calingaert Brian, Palmieri Rachel T, Iversen Edwin S, Bentley Rex C, Halabi Susan, Berchuck Andrew, Schildkraut Joellen M
Department of Community and Family Medicine, Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, NC 27705, USA.
Am J Epidemiol. 2008 May 1;167(9):1059-69. doi: 10.1093/aje/kwn006. Epub 2008 Feb 25.
Ovarian cancer is most frequently diagnosed in postmenopausal women; however, the strongest risk predictors, pregnancy and oral contraceptive use, occur in most women in their twenties and thirties. Relatively few studies have examined how reproductive risk factors vary between pre- and postmenopausal ovarian cancer. The authors used data from a population-based, case-control study of ovarian cancer (896 cases, 967 controls) conducted in North Carolina from 1999 to 2006. Odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression. Inverse associations with ovarian cancer were observed with duration of oral contraceptive use, later age at last use, and more recent use among premenopausal women; no significant associations were found for postmenopausal women. Analyses limited to oral contraceptive users showed that duration was a more significant predictor of risk than was timing of use. Parity was inversely associated with premenopausal but not postmenopausal ovarian cancer. Later age at pregnancy was associated with reduced risk for both pre- and postmenopausal women. Analyses among parous women showed that pregnancy timing was a stronger risk predictor than number of pregnancies. Findings suggest that associations between ovarian cancer and reproductive characteristics vary by menopausal status. Additional research is needed to further elucidate risk factors for postmenopausal disease.
卵巢癌最常被诊断于绝经后女性；然而，最强的风险预测因素，即怀孕和口服避孕药的使用，却出现在大多数二三十岁的女性中。相对较少的研究探讨了绝经前和绝经后卵巢癌的生殖风险因素如何不同。作者使用了1999年至2006年在北卡罗来纳州进行的一项基于人群的卵巢癌病例对照研究（896例病例，967例对照）的数据。通过无条件逻辑回归计算比值比和95%置信区间。在绝经前女性中，观察到口服避孕药使用时间、最后一次使用时年龄较大以及最近使用与卵巢癌呈负相关；绝经后女性未发现显著关联。仅限于口服避孕药使用者的分析表明，使用时间比使用时机是更显著的风险预测因素。产次与绝经前而非绝经后卵巢癌呈负相关。怀孕时年龄较大与绝经前和绝经后女性的风险降低相关。经产妇的分析表明，怀孕时机比怀孕次数是更强的风险预测因素。研究结果表明，卵巢癌与生殖特征之间的关联因绝经状态而异。需要进一步的研究来进一步阐明绝经后疾病的风险因素。
