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多囊卵巢综合征女性的癌症风险:一项丹麦队列研究。

Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study.

机构信息

Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.

Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen DK-2100, Denmark.

出版信息

Gynecol Oncol. 2015 Jan;136(1):99-103. doi: 10.1016/j.ygyno.2014.11.012. Epub 2014 Nov 20.

Abstract

OBJECTIVE

To assess the association between polycystic ovary syndrome (PCOS) and cancer, especially of the endometrium, breast and ovary.

METHODS

The Danish National Patient Register was used to identify 12,070 in- and outpatients in whom PCOS was diagnosed when they were aged 9-49 years during 1977-2012. Using the Danish Cancer Registry, we followed the cohort through 2012 and compared the women's cancer incidence with that of the general Danish female population by means of standardized incidence ratios (SIRs).

RESULTS

Cancer was diagnosed in 279 women with PCOS (SIR = 1.19; 95% CI = 1.06-1.34). We found an almost fourfold increased risk for endometrial cancer (numbers observed (N) = 16, SIR = 3.9; 95% CI = 2.2-6.3), the large majority of cases being type 1 (N = 14, SIR = 4.7; 95% CI = 2.6-7.9). We found no association between PCOS and breast (N = 59, SIR = 1.1; 95% CI = 0.8-1.4) or ovarian cancer (N = 10, SIR = 1.8; 95% CI = 0.8-3.2); however, significantly increased risks were found for kidney, colon and brain cancers.

CONCLUSION

The results of this large cohort study support those of case-control studies showing that women with PCOS are at increased risk for endometrial cancer, whereas their risks for breast and ovarian cancer are similar to those of women in the general population. Our finding that women with PCOS also are at increased risk for cancers of the kidney, colon and brain requires further study.

摘要

目的

评估多囊卵巢综合征(PCOS)与癌症之间的关联,特别是子宫内膜癌、乳腺癌和卵巢癌。

方法

利用丹麦全国患者登记系统,我们确定了 12070 名在 1977 年至 2012 年期间 9 至 49 岁时被诊断患有 PCOS 的门诊和住院患者。利用丹麦癌症登记系统,我们对该队列进行了随访,并通过标准化发病率比(SIR)比较了这些女性的癌症发病率与丹麦一般女性人群的发病率。

结果

在 279 名患有 PCOS 的女性中诊断出癌症(SIR = 1.19;95%CI = 1.06-1.34)。我们发现子宫内膜癌的风险几乎增加了四倍(观察到的病例数(N)= 16,SIR = 3.9;95%CI = 2.2-6.3),其中绝大多数为 1 型(N = 14,SIR = 4.7;95%CI = 2.6-7.9)。我们未发现 PCOS 与乳腺癌(N = 59,SIR = 1.1;95%CI = 0.8-1.4)或卵巢癌(N = 10,SIR = 1.8;95%CI = 0.8-3.2)之间存在关联;然而,我们发现肾癌、结肠癌和脑癌的风险显著增加。

结论

这项大型队列研究的结果支持病例对照研究的结果,表明患有 PCOS 的女性患子宫内膜癌的风险增加,而她们患乳腺癌和卵巢癌的风险与普通人群相似。我们发现患有 PCOS 的女性患肾癌、结肠癌和脑癌的风险也增加,这需要进一步研究。

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