Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.
Obstet Gynecol. 2015 Jan;125(1):89-98. doi: 10.1097/AOG.0000000000000563.
To obtain precise estimates of endometrial cancer risk associated with a family history of endometrial cancer or cancers at other sites.
For the systematic review, we used PubMed to search for all relevant studies on family history and endometrial cancer that were published before December 2013. Medical Subject Heading terms "endometrial neoplasm" and "uterine neoplasm" were used in combination with one of the key phrases "family history," "first-degree," "familial risk," "aggregation," or "relatedness."
Studies were included if they were case-control or cohort studies that investigated the association between a family history of cancer specified to site and endometrial cancer. Studies were excluded if they were review or editorial articles or not translated into English or did not define family history clearly or used spouses as control participants.
TABULATION, INTEGRATION, AND RESULTS: We included 16 studies containing 3,871 women as cases and 49,475 women as controls from 10 case-control studies and 33,510 women as cases from six cohort studies. We conducted meta-analyses to estimate the pooled relative risk (95% confidence interval [CI]) of endometrial cancer associated with a first-degree family history of endometrial, colorectal, breast, ovarian, and cervical cancer to be: 1.82 (1.65-1.98), 1.17 (1.03-1.31), 0.96 (0.88-1.04), 1.13 (0.85-1.41), and 1.19 (0.83-1.55), respectively. We estimated cumulative risk of endometrial cancer to age 70 years to be 3.1% (95% CI 2.8-3.4) for women with a first-degree relative with endometrial cancer and the population-attributable risk to be 3.5% (95% CI 2.8-4.2).
Women with a first-degree family history of endometrial cancer or colorectal cancer have a higher risk of developing endometrial cancer than those without a family history. This study is likely to be of clinical relevance to inform women of their risk of endometrial cancer.
获得与子宫内膜癌或其他部位癌症家族史相关的子宫内膜癌风险的准确估计。
为了进行系统评价，我们使用 PubMed 搜索了截至 2013 年 12 月所有关于家族史与子宫内膜癌的相关研究。我们使用了医学主题词“子宫内膜肿瘤”和“子宫肿瘤”，并结合了“家族史”、“一级亲属”、“家族风险”、“聚集”或“相关性”等关键词之一。
纳入的研究为病例对照或队列研究，调查了特定部位癌症家族史与子宫内膜癌之间的关联。排除的研究为综述或社论文章，或未翻译成英文，或未明确界定家族史，或使用配偶作为对照参与者的文章。
列表、综合和结果：我们纳入了 10 项病例对照研究中的 16 项研究，这些研究共纳入 3871 例病例和 49475 例对照，以及 6 项队列研究中的 33510 例病例。我们进行了荟萃分析，以估计一级亲属子宫内膜癌、结直肠癌、乳腺癌、卵巢癌和宫颈癌家族史与子宫内膜癌相关的合并相对风险（95%置信区间[CI]）分别为：1.82（1.65-1.98）、1.17（1.03-1.31）、0.96（0.88-1.04）、1.13（0.85-1.41）和 1.19（0.83-1.55）。我们估计一级亲属有子宫内膜癌的女性到 70 岁时的子宫内膜癌累积风险为 3.1%（95%CI 2.8-3.4），人群归因风险为 3.5%（95%CI 2.8-4.2）。
一级亲属有子宫内膜癌或结直肠癌病史的女性发生子宫内膜癌的风险高于无家族史的女性。这项研究可能对告知女性子宫内膜癌风险具有临床意义。
