Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Breast. 2010 Jun;19(3):198-201. doi: 10.1016/j.breast.2010.01.021. Epub 2010 Feb 21.
Studies conducted in different areas of North America and Europe showed a 5-10% decline in the incidence of breast cancer following reductions up to 70% in menopause hormone therapy (HT) use after 2002. The observation that the decline was larger in (or limited to) women aged > or =50 years weighs in favour of an effect of reduced HT use on breast cancer incidence. However, changes in screening are also likely to play a role in the decreasing incidence of breast cancer observed in several countries. In particular, the technical improvements and the increased effectiveness of breast cancer screening and detection during the 1990s led to a decreased number of pre-clinical cases found by screening in subsequent years. Further, disentangling the effects of HT use and screening is difficult, as women who stop using HT may also undergo mammography screening less frequently. Thus, the reasons of the falls in incidence remain open to discussion.
在北美和欧洲的不同地区进行的研究表明，2002 年后，绝经后激素疗法（HT）的使用减少了 70%，乳腺癌的发病率下降了 5-10%。观察到这种下降在（或仅限于）年龄≥50 岁的女性中更大，这有利于减少 HT 使用对乳腺癌发病率的影响。然而，筛查的变化也可能在几个国家观察到的乳腺癌发病率下降中发挥作用。特别是，20 世纪 90 年代乳腺癌筛查和检测技术的改进和有效性的提高，导致随后几年筛查发现的临床前病例数量减少。此外，由于停止使用 HT 的女性也可能不太频繁地进行乳房 X 线筛查，因此很难区分 HT 使用和筛查的影响。因此，发病率下降的原因仍有待讨论。
