Lee Jung Eun, Hankinson Susan E, Cho Eunyoung
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Am J Epidemiol. 2009 May 15;169(10):1243-50. doi: 10.1093/aje/kwp030. Epub 2009 Mar 27.
Few prospective studies have examined associations between reproductive factors and risk of renal cell cancer (RCC). The authors prospectively examined whether postmenopausal hormone (PMH) use, oral contraceptive use, parity, and other reproductive factors were associated with RCC risk among 118,219 US women in the Nurses' Health Study. A total of 247 RCC cases were confirmed between 1976 and 2004. Multivariate relative risks, adjusted for known risk factors, were calculated using Cox proportional hazards models. Compared with 1 or 2 childbirths, the multivariate relative risks were 1.75 (95% confidence interval (CI): 1.21, 2.53) for 4 childbirths and 1.50 (95% CI: 1.00, 2.23) for > or =5 childbirths (P(trend) = 0.02). Comparing an age at first birth of > or =28 years with an age at first birth of < or =22 years, the multivariate relative risk was 0.66 (95% CI: 0.43, 1.01; P(trend) = 0.01). Compared with 1-3 childbirths and an age at first birth of > or =26 years, the multivariate relative risk was 2.17 (95% CI: 1.49, 3.14) for > or =4 childbirths and an age at first birth of <26 years. No clear associations were observed for PMH use or duration, time since last PMH use, oral contraceptive use or duration, age at menarche, age at menopause, or history of hysterectomy or oophorectomy.
很少有前瞻性研究探讨生殖因素与肾细胞癌(RCC)风险之间的关联。作者在护士健康研究中对118219名美国女性进行了前瞻性研究,以检验绝经后激素(PMH)使用、口服避孕药使用、生育情况及其他生殖因素是否与RCC风险相关。1976年至2004年间共确诊了247例RCC病例。使用Cox比例风险模型计算了经已知风险因素调整后的多变量相对风险。与生育1或2次相比,生育4次的多变量相对风险为1.75(95%置信区间(CI):1.21,2.53),生育≥5次的多变量相对风险为1.50(95%CI:1.00,2.23)(P趋势=0.02)。将初产年龄≥28岁与初产年龄≤22岁进行比较,多变量相对风险为0.66(95%CI:0.43,1.01;P趋势=0.01)。与生育1 - 3次且初产年龄≥26岁相比,生育≥4次且初产年龄<26岁的多变量相对风险为2.17(95%CI:1.49,3.14)。未观察到PMH使用或使用时长、末次使用PMH后的时间、口服避孕药使用或使用时长、初潮年龄、绝经年龄或子宫切除术或卵巢切除术史之间存在明确关联。