Department of Gynecology, the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830011, China ; Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
Chin J Cancer Res. 2012 Mar;24(1):9-17. doi: 10.1007/s11670-012-0009-y.
To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors (RFs, including nulliparity, mean number of children, age at first birth and breastfeeding), use of oral contraceptives (OCs, restricted to the age group of 15-49 years), and hormone replacement therapy (HRT), as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005.
We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China. In the case of RFs, we compared the exposure distributions in 2001 and counterfactual exposure.
Exposure of RFs in 2001 was found to account for 6.74% of breast cancer, corresponding to 9,617 cases and 2,769 deaths, and for 2.78% of ovarian cancer (711 cases, 294 deaths). The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer. The prevalence of OC use was 1.74% and the population attributable fraction (PAF) of breast cancer was 0.71%, corresponding to 310 cases and 90 deaths. The PAF of breast cancer due to HRT was 0.31%, resulting in 297 cases and 85 deaths.
RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.
提供基于证据的、一致的评估，以了解生殖因素（RF，包括未婚、平均子女数、首次生育年龄和母乳喂养）、口服避孕药（OC，限于 15-49 岁年龄组）和激素替代疗法（HRT）对乳腺癌负担的归因，以及中国 2005 年卵巢癌负担归因于平均子女数的情况。
我们从中国进行的全国调查或大规模研究中得出了这些风险因素的患病率和乳腺癌和卵巢癌的相对风险。对于 RF，我们比较了 2001 年的暴露分布和反事实暴露。
2001 年 RF 的暴露被认为占乳腺癌的 6.74%，对应 9617 例和 2769 例死亡，占卵巢癌的 2.78%（711 例，294 例死亡）。仅平均子女数的减少就导致 1.47%的乳腺癌和 2.78%的卵巢癌。OC 使用的流行率为 1.74%，乳腺癌的人群归因分数（PAF）为 0.71%，对应 310 例和 90 例死亡。HRT 导致的乳腺癌 PAF 为 0.31%，导致 297 例和 85 例死亡。
中国 RF 变化导致乳腺癌和卵巢癌的发病率和死亡率相当大，而 HRT 和 OC 在中国仅导致相对较低的乳腺癌发病率。
