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生育次数、初产年龄与肾癌死亡风险:台湾一项基于人群的队列研究

Parity, age at first birth and risk of death from kidney cancer: a population-based cohort study in Taiwan.

作者信息

Chiu Hui-Fen, Kuo Chien-Chun, Kuo Hsin-Wei, Lee I-Ming, Yang Chun-Yuh

机构信息

1 Institute of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Eur J Public Health. 2014 Apr;24(2):249-52. doi: 10.1093/eurpub/ckt057. Epub 2013 Jun 6.

Abstract

BACKGROUND

This study was undertaken to examine whether there is an association between parity and age at first birth and risk of kidney cancer.

METHODS

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 her first childbirth to 31 December 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) of death from kidney cancer associated with parity and age at first birth.

RESULTS

There were 95 kidney cancer deaths during 34,980,246 person-years of follow-up. The mortality rate of kidney cancer was 0.27 cases per 100,000 person-years. The adjusted HR was 1.88 [95% confidence interval (CI) 1.10-3.19] for women who gave birth between 24 and 26 years of age and 2.52 (95% CI 1.44-4.40) for women who gave birth after 26 years of age, when compared with women who gave birth when <23 years of age. A trend of increasing risk of kidney cancer was seen with increasing age at first birth. The adjusted HR was 0.88 (95% CI 0.49-1.59) for women who had two children and 0.89 (95% CI 0.47-1.67) for women with three or more births, when compared with women who had given birth to only one child.

CONCLUSION

This study is the first to suggest that early age at first birth may confer a protective effect on the risk of kidney cancer.

摘要

背景

本研究旨在探讨生育次数和首次生育年龄与肾癌风险之间是否存在关联。

方法

研究队列包括1292462名在1978年1月1日至1987年12月31日期间首次生育且为单胎分娩的女性。我们从每位女性首次分娩时开始追踪,直至2009年12月31日,并通过将记录与计算机化死亡率数据库相链接来确定她们的生命状态。采用Cox比例风险回归模型来估计与生育次数和首次生育年龄相关的肾癌死亡风险比(HRs)。

结果

在34980246人年的随访期间,有95例肾癌死亡病例。肾癌死亡率为每100000人年0.27例。与首次生育年龄小于23岁的女性相比,24至26岁分娩的女性调整后的HR为1.88[95%置信区间(CI)1.10 - 3.19],26岁以后分娩的女性调整后的HR为2.52(95%CI 1.44 - 4.40)。首次生育年龄越大,患肾癌的风险呈上升趋势。与只生育一个孩子的女性相比,生育两个孩子的女性调整后的HR为0.88(95%CI 0.49 - 1.59),生育三个或更多孩子的女性调整后的HR为0.89(95%CI 0.47 - 1.67)。

结论

本研究首次表明,早育可能对肾癌风险具有保护作用。

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