Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital- Kaohsiung Medical Center, College of Medicine, Chang Gung University, Kaohsiung, Taiwan.
J Gastroenterol Hepatol. 2011 Feb;26(2):334-9. doi: 10.1111/j.1440-1746.2010.06365.x.
The present study was undertaken to examine whether there is an association between parity and age at first birth and risk of liver cancer.
The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We tracked each woman from the time of their first childbirth to 31 December 2007, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the relative risks (RR) of death from liver cancer associated with parity and age at first birth.
There were 826 liver cancer deaths during 32,464,186.58 person-years of follow-up. The mortality rate of liver cancer was 2.54 cases per 100,000 person-years. The adjusted RR was 1.59 (95% confidence interval [CI] = 1.36-1.86) for women who gave birth between 26 and 30, 2.41 (95% CI = 1.81-3.20) for women who gave birth between 31 and 35, and 6.26 (95% CI = 4.27-9.19) for women who gave birth after 35 years of age, respectively, when compared with women who gave birth at less than 25 years of age. The adjusted RR was 0.72 (95% CI = 0.59-0.87) for women who had two to three children, and 0.63 (95% CI = 0.47-0.84) for women with four or more births, respectively, when compared with women who had given birth to only one child.
The present study suggests that reproductive factors (parity and early age at first birth) may confer a protective effect on the risk of liver cancer.
本研究旨在探讨初产年龄和生育胎次与肝癌风险之间是否存在关联。
本研究队列纳入了 1978 年 1 月 1 日至 1987 年 12 月 31 日期间首次分娩且单胎的 1292462 名女性。我们从每位女性首次分娩开始追踪,随访至 2007 年 12 月 31 日,通过与计算机化死亡数据库记录链接来确定其生存状态。使用 Cox 比例风险回归模型来估计与生育胎次和初产年龄相关的肝癌死亡的相对风险(RR)。
在 32464186.58 人年的随访期间,共发生 826 例肝癌死亡。肝癌的死亡率为 2.54 例/10 万人年。与小于 25 岁生育的女性相比,生育年龄在 26-30 岁、31-35 岁和 35 岁以上的女性的调整 RR 分别为 1.59(95%可信区间[CI] = 1.36-1.86)、2.41(95% CI = 1.81-3.20)和 6.26(95% CI = 4.27-9.19)。与生育一胎的女性相比,生育 2-3 胎和 4 胎以上的女性的调整 RR 分别为 0.72(95% CI = 0.59-0.87)和 0.63(95% CI = 0.47-0.84)。
本研究表明,生育因素(生育胎次和初产年龄)可能对肝癌风险具有保护作用。