McDonald T W, Annegers J F, O'Fallon W M, Dockerty M B, Malkasian G D, Kurland L T
Am J Obstet Gynecol. 1977 Mar 15;127(6):572-80. doi: 10.1016/0002-9378(77)90351-9.
Recent independent case-control studies have indicated that treatment with exogenous estrogen is associated with an increase in the risk of endometrial cancer. This question was studied in Olmsted County, Minnesota, by identifying all cases of endometrial cancer among residents over a 30 year period (1945 through 1974) and by matching four controls to each of the 145 patients. The rate of past exposure to any exogenous estrogen for any duration was about the same for patients as for controls. However, the estimated relative risk of endometrial cancer associated with conjugated estrogen treatment of 6 months or longer was 4.9 (P less than 0.01), and this increased to 7.9 (P less than 0.01) with exposure for 3 years or longer. The risk increased with larger doses (1.25 mg. or more) and continuous administration of conjugated estrogens. The incidence of endometrial carcinoma over the three decades of the study, corrected for an increasing rate of hysterectomy, was constant. Thus to this time, the low rate of use of conjugated estrogens in this region over the past 30 years apparently has not had an appreciable impact on the incidence of endometrial cancer.
近期独立的病例对照研究表明，外源性雌激素治疗与子宫内膜癌风险增加有关。在明尼苏达州的奥尔姆斯特德县对这个问题进行了研究，通过确定30年期间（1945年至1974年）居民中的所有子宫内膜癌病例，并为145名患者中的每一位匹配4名对照。患者和对照过去接触任何外源性雌激素的任何时长的比例大致相同。然而，与结合雌激素治疗6个月或更长时间相关的子宫内膜癌估计相对风险为4.9（P小于0.01），暴露3年或更长时间时这一风险增加到7.9（P小于0.01）。风险随着结合雌激素剂量增大（1.25毫克或更多）以及持续给药而增加。在研究的三十年中，校正子宫切除率上升因素后，子宫内膜癌的发病率保持稳定。因此，到目前为止，过去30年该地区结合雌激素的低使用率显然对子宫内膜癌的发病率没有明显影响。
