Benyi Emelie, Kieler Helle, Linder Marie, Ritzén Martin, Carlstedt-Duke Jan, Tuvemo Torsten, Westphal Otto, Sävendahl Lars
Paediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Horm Res Paediatr. 2014;82(2):89-96. doi: 10.1159/000360137. Epub 2014 Jun 11.
BACKGROUND/AIM: High-dose oestrogen treatment has been used to reduce growth in tall adolescent girls. The long-term safety with regard to cancer has not been clarified. Our aim was to study if this growth reduction therapy affects cancer risk later in life.
A cohort study of 369 (172 treated, 197 untreated) Swedish women who in 1973-1993 were assessed for tall adolescent stature was designed. Data were collected from university hospital records, patient questionnaires, and the Swedish Cancer Register.
Risks are presented as odds ratios (ORs) with 95% confidence intervals comparing treated to untreated subjects. In treated subjects, the overall OR for having a tumour (malignant or non-malignant) was 1.7 (0.8-3.8). The ORs were 2.3 (0.4-12.8) for breast tumours, 0.8 (0.2-2.6) for gynaecological tumours, and 6.1 (1.04-∞) for melanoma. When limiting to malignant tumours, the crude ORs were of similar magnitude.
The OR for any melanoma was higher in treated than in untreated women, suggesting an increased risk of melanoma associated with high-dose oestrogen treatment during adolescence. Although the risk estimates were increased for overall tumours, breast tumours, malignant gynaecological tumours, and malignant melanoma, these associations were not statistically significant. Our results need to be verified in a larger cohort.
背景/目的:高剂量雌激素治疗已被用于抑制青春期高个子女孩的生长。其在癌症方面的长期安全性尚未明确。我们的目的是研究这种生长抑制疗法是否会影响这些女性日后患癌风险。
设计了一项队列研究,纳入369名瑞典女性(172名接受治疗,197名未接受治疗),她们在1973年至1993年期间因青春期身材高大接受评估。数据收集自大学医院记录、患者问卷以及瑞典癌症登记处。
风险以比值比(OR)及95%置信区间表示,对比接受治疗与未接受治疗的受试者。在接受治疗的受试者中,患肿瘤(恶性或非恶性)的总体OR为1.7(0.8 - 3.8)。乳腺癌的OR为2.3(0.4 - 12.8),妇科肿瘤的OR为0.8(0.2 - 2.6),黑色素瘤的OR为6.1(1.04 - ∞)。若仅考虑恶性肿瘤,粗OR值幅度相近。
接受治疗的女性患黑色素瘤的OR高于未接受治疗的女性,提示青春期高剂量雌激素治疗与黑色素瘤风险增加相关。尽管总体肿瘤、乳腺癌、恶性妇科肿瘤及恶性黑色素瘤的风险估计值有所增加,但这些关联无统计学意义。我们的结果需要在更大的队列中进行验证。