Zhou Bo, Yang Li, Sun Qingmin, Cong Rihong, Gu Haijuan, Tang Naping, Zhu Huaijun, Wang Bin
Key Laboratory of Reproductive Medicine, Department of Pharmacology, Nanjing Medical University, Nanjing, Jiangsu Province, China.
Am J Med. 2008 Jun;121(6):501-508.e3. doi: 10.1016/j.amjmed.2008.01.044.
Epidemiologic findings are inconsistent concerning the association of endometrial cancer risk with cigarette smoking. We conducted a meta-analysis of epidemiologic studies to examine this relation.
A systematic literature search up to June of 2007 was performed in MEDLINE and EMBASE. Study-specific risk estimates were pooled using a random-effects model.
Ten prospective and 24 case-control studies were included in the analysis of the effect of ever smoking. Ever smoking was statistically significantly associated with a reduced risk of endometrial cancer among prospective studies (relative risk 0.81; 95% confidence interval [CI], 0.74-0.88) and case-control studies (odds ratio 0.72; 95% CI, 0.66-0.79). The inverse association was significant among current and former smokers. Six prospective and 6 case-control studies were included in the quantitative analysis. We noted that an increase in smoking of 20 cigarettes per day was statistically significantly associated with 16% and 27% reduced risks of endometrial cancer in prospective and case-control studies, respectively. We also found that cigarette smoking was significantly associated with a decreased risk of endometrial cancer among postmenopausal women (relative risk 0.71; 95% CI, 0.65-0.78) but not among premenopausal women. In addition, the risk reduction seemed to be stronger among hormone replacement therapy users than nonusers.
Cigarette smoking was found to be significantly associated with a reduced risk of endometrial cancer, especially among postmenopausal women.
关于子宫内膜癌风险与吸烟之间的关联，流行病学研究结果并不一致。我们进行了一项流行病学研究的荟萃分析，以检验这种关系。
截至2007年6月，在MEDLINE和EMBASE中进行了系统的文献检索。使用随机效应模型汇总特定研究的风险估计值。
在曾经吸烟影响的分析中纳入了10项前瞻性研究和24项病例对照研究。在前瞻性研究（相对风险0.81；95%置信区间[CI]，0.74 - 0.88）和病例对照研究（比值比0.72；95% CI，0.66 - 0.79）中，曾经吸烟与子宫内膜癌风险降低在统计学上显著相关。当前吸烟者和既往吸烟者中这种反向关联显著。定量分析纳入了6项前瞻性研究和6项病例对照研究。我们注意到，每天吸烟量增加20支，在前瞻性研究和病例对照研究中分别与子宫内膜癌风险降低16%和27%在统计学上显著相关。我们还发现，吸烟与绝经后女性子宫内膜癌风险降低显著相关（相对风险0.71；95% CI，0.65 - 0.78），但在绝经前女性中并非如此。此外，激素替代疗法使用者中风险降低似乎比非使用者更强。
发现吸烟与子宫内膜癌风险降低显著相关，尤其是在绝经后女性中。
