Tsai Ming-Shian, Chen Hsin-Pao, Hung Chao-Ming, Lee Po-Huang, Lin Cheng-Li, Kao Chia-Hung
Department of General Surgery, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan.
Ann Surg Oncol. 2015;22(6):1996-2002. doi: 10.1245/s10434-014-4198-0. Epub 2014 Oct 30.
To learn whether women with inflammatory bowel disease (IBD) exhibit a higher risk of breast cancer.
We identified 4,856 women with IBD symptoms from 1998 to 2008 and 19,424 control patients without the disorder, frequency matched by age, sex, and admission year. Both cohorts were followed-up until the end of 2010 to estimate the risk of breast cancer.
Overall, the incidence of breast cancer was similar in the IBD and control cohorts (1.31 vs. 1.25 per 1,000 person-years). The adjusted hazard ratio of breast cancer was 0.95 (95 % confidence interval 0.66-1.36) for the IBD patients. Further analysis revealed that neither Crohn disease nor ulcerative colitis was associated with the risk of developing breast cancer in women. The age-specific analysis indicated that the incidence of breast cancer was highest in the 45- to 65-year-old age group in both cohorts. The incidence of breast cancer was significantly increased in patients who required hospitalization twice or more per year, compared with the control cohort (adjusted hazard ratio 8.45; 95 % confidence interval 4.64-15.4). Moreover, age-specific analysis showed that patients aged less than 65 years old (≤44 or 45-65 years of age) exhibited a strong association between IBD hospitalization and breast cancer risk.
The risk of breast cancer was positively proportional to the frequency of admission for IBD. Therefore, careful surveillance of breast cancer should be sought for female IBD patients with 2 or more annual hospitalizations.
了解炎症性肠病(IBD)女性患者患乳腺癌的风险是否更高。
我们从1998年至2008年确定了4856名有IBD症状的女性以及19424名无该疾病的对照患者,根据年龄、性别和入院年份进行频数匹配。两个队列均随访至2010年底,以评估患乳腺癌的风险。
总体而言,IBD队列和对照队列中乳腺癌的发病率相似(每1000人年分别为1.31和1.25)。IBD患者患乳腺癌的校正风险比为0.95(95%置信区间0.66 - 1.36)。进一步分析显示,克罗恩病和溃疡性结肠炎均与女性患乳腺癌的风险无关。年龄特异性分析表明,两个队列中45至65岁年龄组的乳腺癌发病率最高。与对照队列相比,每年需要住院两次或更多次的患者中乳腺癌发病率显著增加(校正风险比8.45;95%置信区间4.64 - 15.4)。此外,年龄特异性分析表明,年龄小于65岁(≤44岁或45 - 65岁)的患者中,IBD住院与乳腺癌风险之间存在密切关联。
乳腺癌风险与IBD的入院频率成正比。因此,对于每年住院两次或更多次的女性IBD患者,应进行仔细的乳腺癌监测。