Nutrition and Metabolism Section/Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France.
PLoS One. 2013 Nov 15;8(11):e79695. doi: 10.1371/journal.pone.0079695. eCollection 2013.
The use of hormonal therapies, including hormonal contraceptives (HC) and postmenopausal hormone replacement therapy (HRT) have been shown to influence breast cancer (BC) risk. However, the variations of these effects among populations and ethnic groups are not completely documented, especially among Hispanic women. We evaluated the association between HC and premenopausal BC risk, and between HRT and postmenopausal BC risk in Mexican women. Data from a Mexican multi-center population-based case-control study ofwomen aged 35 to 69 years were analysed. A total of 1000 cases and 1074 matched controls were recruited between 2004 and 2007. Information on hormonal therapy was collected through a structured questionnaire. Results were analysed using conditional logistic regression models. Overall, HC were used by 422/891 (47.3%) premenopausal women and HRT was used by 220/1117 (19.7%) postmenopausal women. For HC, odds ratios (ORs) for BC were 1.11 (95% confidence interval (CI): 0.82, 1.49) for current users and 1.68 (95% CI: 0.67, 4.21) for ever-users. No clear effect of duration of use was observed. For HRT, the OR for BC was significantly increased in ever users (OR: 1.45; 95% CI: 1.01, 2.08). A non-significant increased risk was observed for combined estrogen/progestin, (OR = 1.85; 95% CI: 0.84, 4.07) whereas no effect was observed for the use of estrogen alone (OR = 1.14; 95% CI: 0.68, 1.91). Our results indicate that, HC had a non-significant effect on the risk of pre-menopausal BC, but suggested that injected contraceptives may slightly increase the risk, whereas HRT had a significant effect on post-menopausal BC in this population. This study provides new information about the effects of HC and HRT on BC risk in a Mexican population, which may be of relevance for the population of Latin America as a whole.
激素疗法的使用,包括激素避孕药(HC)和绝经后激素替代疗法(HRT),已被证明会影响乳腺癌(BC)的风险。然而,这些影响在人群和种族群体中的差异并没有完全记录下来,尤其是在西班牙裔女性中。我们评估了 HC 与绝经前 BC 风险之间的关系,以及 HRT 与绝经后 BC 风险之间的关系在墨西哥妇女中。对 2004 年至 2007 年期间年龄在 35 至 69 岁的墨西哥多中心人群为基础的病例对照研究的数据进行了分析。共招募了 1000 例病例和 1074 例匹配对照。通过结构化问卷收集激素治疗信息。使用条件逻辑回归模型分析结果。总体而言,422/891(47.3%)名绝经前妇女使用 HC,220/1117(19.7%)名绝经后妇女使用 HRT。对于 HC,BC 的比值比(OR)为当前使用者 1.11(95%置信区间(CI):0.82,1.49),既往使用者 1.68(95%CI:0.67,4.21)。使用时间长短对其影响并不明显。对于 HRT,既往使用者的 BC 风险显著增加(OR:1.45;95%CI:1.01,2.08)。联合使用雌激素/孕激素的风险略有增加(OR=1.85;95%CI:0.84,4.07),而单独使用雌激素则没有影响(OR=1.14;95%CI:0.68,1.91)。我们的结果表明,HC 对绝经前 BC 的风险无显著影响,但提示注射避孕药可能会略微增加风险,而 HRT 在该人群中对绝经后 BC 有显著影响。这项研究提供了关于 HC 和 HRT 对墨西哥人群中 BC 风险影响的新信息,这可能对整个拉丁美洲人群具有重要意义。