Jung Sun Jae, Song Minkyo, Choi Ji-Yeob, Song Nan, Park Sue Kyung, Yoo Keun-Young, Kang Daehee
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. ; Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.
J Prev Med Public Health. 2013 Nov;46(6):346-52. doi: 10.3961/jpmph.2013.46.6.346. Epub 2013 Nov 28.
To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study.
The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer.
Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer.
Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.
在一项病例对照研究中评估韩国人群中的疾病状况对乳腺癌风险的影响。
病例为2001年至2007年间在两家主要医院接受访谈的3242例新发的、经组织学确诊的乳腺癌女性患者。对照为因各种非肿瘤性疾病入住这两家医院之一的1818例女性。每种疾病的信息由经过培训的人员通过标准化问卷获取。每种疾病的比值比(OR)来自对年龄、初潮年龄、妊娠、首次妊娠年龄和乳腺癌家族史进行调整的多因素逻辑回归分析。
在所有新发乳腺癌患者中,在调整其他因素后,既往患糖尿病(OR,1.33;95%置信区间[CI],0.99至1.78)、高血压(OR,1.46;95%CI,1.18至1.83)、甲状腺疾病(OR,1.26;95%CI,1.00至1.58)和卵巢疾病(OR,1.70;95%CI,1.23至2.35)与乳腺癌风险增加相关。在按绝经状态进行的分层分析中,既往患高血压(绝经前OR,0.80;95%CI,0.48至1.34;绝经后OR,1.87;95%CI,1.44至2.43;异质性p<0.01)和卵巢疾病(绝经前OR,4.20;95%CI,1.91至9.24;绝经后OR,1.39;95%CI,1.02至1.91;异质性p = 0.01)显示出乳腺癌风险存在显著差异。
我们的结果提示高血压等疾病状况可能影响乳腺癌的发生,且这种影响可能因绝经状态而异。我们的研究还表明卵巢疾病与乳腺癌风险之间可能存在关联。