根据前列腺、肺、结肠直肠和卵巢（PLCO）癌筛查试验队列中公认的乳腺癌风险因素得出的乳腺癌流行病学情况。
Breast cancer epidemiology according to recognized breast cancer risk factors in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Cohort.
作者信息
Lacey James V, Kreimer Aimee R, Buys Saundra S, Marcus Pamela M, Chang Shih-Chen, Leitzmann Michael F, Hoover Robert N, Prorok Philip C, Berg Christine D, Hartge Patricia
机构信息
Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
出版信息
BMC Cancer. 2009 Mar 17;9:84. doi: 10.1186/1471-2407-9-84.
BACKGROUND
Multidisciplinary attempts to understand the etiology of breast cancer are expanding to increasingly include new potential markers of disease risk. Those efforts may have maximal scientific and practical influence if new findings are placed in context of the well-understood lifestyle and reproductive risk factors or existing risk prediction models for breast cancer. We therefore evaluated known risk factors for breast cancer in a cancer screening trial that does not have breast cancer as a study endpoint but is large enough to provide numerous analytic opportunities for breast cancer.
METHODS
We evaluated risk factors for breast cancer (N = 2085) among 70,575 women who were randomized in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Using Poisson regression, we calculated adjusted relative risks [RRs, with 95% confidence intervals (CIs)] for lifestyle and reproductive factors during an average of 5 years of follow-up from date of randomization.
RESULTS
As expected, increasing age, nulliparity, positive family history of breast cancer, and use of menopausal hormone therapy were positively associated with breast cancer. Later age at menarche (16 years or older vs. < 12: RR = 0.81, 95% CI, 0.65-1.02) or menopause (55 years or older vs. < 45: RR = 1.29, 95% CI, 1.03-1.62) were less strongly associated with breast cancer than was expected. There were weak positive associations between taller height and heavier weight, and only severe obesity [body mass index (BMI; kg/m(2)) 35 or more vs. 18.5-24.9: RR = 1.21, 95% CI, 1.02-1.43] was statistically significantly associated with breast cancer.
CONCLUSION
The ongoing PLCO trial offers continued opportunities for new breast cancer investigations, but these analyses suggest that the associations between breast cancer and age at menarche, age at menopause, and obesity might be changing as the underlying demographics of these factors change.
CLINICAL TRIALS REGISTRATION
(http://www.clinicaltrials.gov), NCT00002540.
背景
多学科对乳腺癌病因的研究不断扩展，越来越多地纳入疾病风险的新潜在标志物。如果将新发现置于已充分了解的生活方式和生殖风险因素或现有的乳腺癌风险预测模型背景下，这些研究可能会产生最大的科学和实际影响。因此，我们在一项癌症筛查试验中评估了已知的乳腺癌风险因素，该试验虽不以乳腺癌作为研究终点，但规模足够大，可为乳腺癌研究提供众多分析机会。
方法
我们在前列腺、肺、结肠和卵巢癌筛查试验中随机分组的70575名女性中评估了乳腺癌风险因素（N = 2085）。使用泊松回归，我们计算了从随机分组日期起平均5年随访期间生活方式和生殖因素的调整相对风险[RRs，95%置信区间（CIs）]。
结果
正如预期的那样，年龄增加、未生育、乳腺癌家族史阳性以及使用绝经后激素治疗与乳腺癌呈正相关。月经初潮年龄较晚（16岁及以上与<12岁相比：RR = 0.81，95%CI，0.65 - 1.02）或绝经年龄较晚（55岁及以上与<45岁相比：RR = 1.29，95%CI，1.03 - 1.62）与乳腺癌的关联强度低于预期。身高较高和体重较重之间存在微弱的正相关，只有重度肥胖[体重指数（BMI；kg/m²）35及以上与18.5 - 24.9相比：RR = 1.21，95%CI，1.02 - 1.43]与乳腺癌存在统计学显著关联。
结论
正在进行的PLCO试验为新的乳腺癌研究提供了持续的机会，但这些分析表明，随着这些因素的潜在人口统计学特征发生变化，乳腺癌与月经初潮年龄、绝经年龄和肥胖之间的关联可能也在改变。
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