Katalinic Alexander, Lemmer Anna, Zawinell Anette, Rawal Rajesh, Waldmann Annika
Institute for Cancer Epidemiology, University of Lübeck, Lübeck, Germany.
Pathobiology. 2009;76(2):90-7. doi: 10.1159/000201677. Epub 2009 Apr 9.
Menopausal hormone therapy (HT) is a proven risk factor for breast cancer. Recent reports presented declining trends in breast cancer incidence, which were attributed to parallel declining trends in HT. Therefore, we analyzed recent data on hormone therapy and breast cancer incidence in Germany.
We performed a population-based survey using breast cancer incidence (from cancer registries) and hormone prescription data (from health insurances) for the time period from 1997 to 2006. Age-standardized rates were calculated and joinpoint regression analyses for trends were performed.
Prescription of HT started to decline in 1999; about 2 years later, a parallel decline in breast cancer incidence was observed. HT prescription decreased by 69% up to 2006, and breast cancer incidence by 6.8% for all age groups (2002-2005) and 12.8% in the age group from 50 to 69 years. The reductions in HT prescription and breast cancer incidence were markedly correlated across the federal states in Germany.
The recent decline in breast cancer incidence following decreasing HT prescription suggests a causal relationship between the risk of breast cancer and HT in Germany. Even after the 'big HT drop' in Germany, significant differences in HT prescription as well as breast cancer incidence persist at the federal state level. These results should be discussed in a public health context.
绝经激素治疗（HT）是已证实的乳腺癌危险因素。近期报告显示乳腺癌发病率呈下降趋势，这归因于HT使用的平行下降趋势。因此，我们分析了德国激素治疗和乳腺癌发病率的近期数据。
我们利用1997年至2006年期间的乳腺癌发病率（来自癌症登记处）和激素处方数据（来自健康保险）进行了一项基于人群的调查。计算年龄标准化率并进行趋势的连接点回归分析。
HT处方量在1999年开始下降；约2年后，观察到乳腺癌发病率平行下降。到2006年，HT处方量下降了69%，所有年龄组的乳腺癌发病率下降了6.8%（2002 - 2005年），50至69岁年龄组下降了12.
