Bouchardy C, Lê M G, Hill C
U287 INSERM, Institut Gustave Roussy, Villejuif, France.
J Clin Epidemiol. 1990;43(3):267-75. doi: 10.1016/0895-4356(90)90007-c.
In a French case-control study of 1010 women with breast cancer and 1950 controls with nonmalignant disease, the variations of the effects of 8 risk factors for breast cancer as a function of age at diagnosis, were analysed by tests of homogeneity and trend. The risks associated with a late age at first full-term pregnancy and with nulliparity were different between age-groups (test of homogeneity: p = 0.03), and the highest risks for these two factors were observed in women 45-54 years old. The risks associated with Quetelet index were also found to vary with age at diagnosis (test for trend: p = 0.008). A high Quetelet index decreased the risk of breast cancer in the younger age-groups; this decrease of risk became progressively less important with advancing age, and no such effect was found in the oldest age-group. Inverse results were observed for a tall stature (test for trend: p = 0.04): a tall stature increased the risk of breast cancer in the younger age-groups, and the figures suggested a reverse effect in the oldest group. No large variation with age was found for the effects of age at menarche, history of breast cancer death in mother or sisters, prior biopsy for benign breast disease, and weight. In conclusion, the relative importance of certain risk factors for breast cancer is closely related to age at diagnosis. Nulliparity and a late age at first birth appear to be major risk factors only for middle-aged women, whereas a low Quetelet index and a tall stature appear to increase the risk of breast cancer only for younger women.
在一项针对1010名乳腺癌女性患者和1950名非恶性疾病对照者的法国病例对照研究中，通过齐性检验和趋势检验分析了8种乳腺癌风险因素的影响随诊断时年龄的变化情况。首次足月妊娠年龄较晚和未生育所带来的风险在不同年龄组之间存在差异（齐性检验：p = 0.03），在45 - 54岁的女性中观察到这两个因素的风险最高。还发现与体重指数相关的风险也随诊断时年龄而变化（趋势检验：p = 0.008）。高体重指数在较年轻年龄组中降低了患乳腺癌的风险；随着年龄增长，这种风险降低的幅度逐渐减小，在最年长的年龄组中未发现这种影响。对于身高较高的情况则观察到相反的结果（趋势检验：p = 0.04）：身高较高在较年轻年龄组中增加了患乳腺癌的风险，数据表明在最年长组中有相反的影响。月经初潮年龄、母亲或姐妹的乳腺癌死亡史、既往良性乳腺疾病活检史以及体重等因素的影响未发现随年龄有大的变化。总之，某些乳腺癌风险因素的相对重要性与诊断时的年龄密切相关。未生育和首次生育年龄较晚似乎仅对中年女性是主要风险因素，而低体重指数和身高较高似乎仅对年轻女性增加了患乳腺癌的风险。
