Ronco Alvaro L, De Stefani Eduardo, Deneo-Pellegrini Hugo
Depto. De Epidemiologia, Facultad de Medicina, IUCLAEH, Uruguay.
Asian Pac J Cancer Prev. 2012;13(6):2879-86. doi: 10.7314/apjcp.2012.13.6.2879.
In order to thoroughly analyze risk factors of breast cancer (BC) in premenopausal Uruguayan women, a case-control study was carried out at the Pereira Rossell Women's Hospital, Montevideo, where 253 incident BC cases and 497 frequency-matched healthy controls were interviewed on menstrual and reproductive story, were administered a short food frequency questionnaire and undertook a series of body measurements necessary to calculate body composition and somatotype. Odds ratio (OR) coefficients were taken as estimates of relative risk derived from unconditional logistic regression. Among the classical risk factors, only the family history of BC in first degree relatives was significantly associated with risk of premenopausal BC (OR=2.20, 95% CI 1.33-3.62). Interestingly, this risk factor was found to be stronger in women of ages >40 (OR=4.05, 95% CI 2.10-7.81), late menarche (OR= 2.39, 95% CI 1.18-4.85), early age for their first delivery (OR=3.02, 95% CI 1.26-7.22), short time between menarche and first delivery (OR=3.22, 95% CI 1.29-8.07), and with high parity (OR=4.10, 95% CI 1.79-9.36), although heterogeneity was detected only for age and parity. High consumption of red meat was positively associated with the disease risk (OR=2.20, 95% CI 1.35-3.60), in the same way as fried foods (OR=1.79, 95% CI 1.12-2.84). Conversely, a high intake of plant foods displayed a protective effect (OR=0.41, 95% CI 0.26-0.65). Except for hypertension (OR=1.55, 95% CI 1.03-2.35), none of the analyzed components of metabolic syndrome were associated to BC risk. Particular increases of risk for premenopausal BC were found for family history in first degree relatives in certain subsets derived from the menstrual-reproductive history. Preventive strategies could broaden their scope if new studies confirm the present results, in view of the limited prevention measures that premenopausal BC currently has.
为了深入分析乌拉圭绝经前女性患乳腺癌(BC)的风险因素,在蒙得维的亚的佩雷拉·罗塞尔妇女医院开展了一项病例对照研究,对253例新发乳腺癌病例和497名频率匹配的健康对照者进行了月经和生育史访谈,让他们填写了一份简短的食物频率问卷,并进行了一系列计算身体成分和体型所需的身体测量。比值比(OR)系数被用作无条件逻辑回归得出的相对风险估计值。在经典风险因素中,只有一级亲属的乳腺癌家族史与绝经前乳腺癌风险显著相关(OR = 2.20,95%可信区间1.33 - 3.62)。有趣的是,发现该风险因素在年龄>40岁的女性中更强(OR = 4.05,95%可信区间2.10 - 7.81),初潮晚(OR = 2.39,95%可信区间1.18 - 4.85),首次分娩年龄早(OR = 3.02,95%可信区间1.26 - 7.22),初潮与首次分娩间隔时间短(OR = 3.22,95%可信区间1.29 - 8.07),以及多产(OR = 4.10,95%可信区间1.79 - 9.36)的女性中更强,不过仅在年龄和产次方面检测到异质性。红肉的高摄入量与疾病风险呈正相关(OR = 2.20,95%可信区间1.35 - 3.60),油炸食品也是如此(OR = 1.79,95%可信区间1.12 - 2.84)。相反,高植物性食物摄入量显示出保护作用(OR = 0.41,95%可信区间0.26 - 0.65)。除高血压外(OR = 1.55,95%可信区间1.03 - 2.35),代谢综合征的分析成分均与乳腺癌风险无关。在月经 - 生育史的某些亚组中,发现一级亲属的家族史会特别增加绝经前乳腺癌的风险。鉴于绝经前乳腺癌目前的预防措施有限,如果新的研究证实当前结果,预防策略可能会扩大其范围。