Adami H O, Zack M, Kressner U, Persson I, Berglund A, Naessén T, Bergkvist L
Department of Surgery, Cancer Epidemiology Unit, University Hospital, Uppsala, Sweden.
Am J Epidemiol. 1990 Nov;132(5):877-83. doi: 10.1093/oxfordjournals.aje.a115730.
The authors investigated whether the incidence of first hip fracture, an indicator of osteoporosis, is lower in breast cancer patients, who are assumed to have higher levels of endogenous estrogens, than in other women. A population-based Swedish cohort comprising 9,673 women with invasive breast cancer diagnosed from 1958 through 1983 was followed up with respect to the occurrence of a first hip fracture during the period 1965-1983. Overall, the number of observed acute fractures (n = 387) was slightly higher than expected (n = 348.6) (standardized incidence ratio (SIR) = 1.1, 95% confidence interval (CI) 1.0-1.2). Risk for trochanteric fractures was slightly higher than expected (SIR = 1.2, 95% CI 1.0-1.4), but risk for cervical fractures was not (SIR = 1.0, 95% CI 0.9-1.1). Risk for trochanteric fracture decreased with increasing age at breast cancer diagnosis, reaching standardized incidence ratios close to unity after the age of 70 years. Duration of follow-up appeared to be unrelated to the risk of either type of fracture. The authors conclude that the incidence of first hip fracture is not lower in breast cancer patients than in other women.
作者调查了骨质疏松症的一个指标——首次髋部骨折的发生率，在假定内源性雌激素水平较高的乳腺癌患者中是否低于其他女性。对一个基于人群的瑞典队列进行了随访，该队列由1958年至1983年诊断为浸润性乳腺癌的9673名女性组成，随访其在1965年至1983年期间首次髋部骨折的发生情况。总体而言，观察到的急性骨折数量（n = 387）略高于预期（n = 348.6）（标准化发病率比（SIR）= 1.1，95%置信区间（CI）1.0 - 1.2）。转子间骨折的风险略高于预期（SIR = 1.2，95% CI 1.0 - 1.4），但颈椎骨折的风险并非如此（SIR = 1.0，95% CI 0.9 - 1.1）。转子间骨折的风险随着乳腺癌诊断时年龄的增加而降低，70岁以后标准化发病率比接近1。随访时间似乎与任何一种骨折的风险无关。作者得出结论，乳腺癌患者首次髋部骨折的发生率并不低于其他女性。
