Chan Te-Fu, Wu Chen-Hsuan, Chiu Hui-Fen, Yang Chun-Yuh
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih Chuan 1st RD, Kaohsiung 807, Taiwan.
Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, 100 Shih‑Chuan 1st RD, Kaohsiung 807, Taiwan.
Int J Environ Res Public Health. 2015 Feb 5;12(2):1864-73. doi: 10.3390/ijerph120201864.
Little epidemiologic research has been done on the etiology of gallbladder cancer (GC). This cohort study was undertaken to examine whether there is an association between parity and risk of death from GC. The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We tracked each woman from the time of their first childbirth to 31 December 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) of death from GC associated with parity. There were 257 GC deaths during 34,980,246 person-years of follow-up. The mortality rate of GC was 0.73 cases per 100,000 person-years. As compared with women who had given birth to only one child, the adjusted HR was 1.20 (95% CI = 0.79-1.83) for women who had two children, 1.47 (95% CI = 0.95-2.29) for women who had three children, and 1.68 (95% CI = 0.99-2.85) for women with four or more births. There was a significant increasing trend in the adjusted HRs for GC with increasing parity. The findings suggested that premenopausal women of higher parity may increase the risk of death from GC.
关于胆囊癌(GC)病因的流行病学研究较少。本队列研究旨在探讨生育次数与GC死亡风险之间是否存在关联。研究队列由1,292,462名在1978年1月1日至1987年12月31日期间首次生育且为单胎的女性组成。我们从每位女性首次分娩时开始追踪,直至2009年12月31日,并通过将记录与计算机化死亡率数据库相链接来确定她们的生命状态。使用Cox比例风险回归模型来估计与生育次数相关的GC死亡风险比(HR)。在34,980,246人年的随访期间,有257例GC死亡。GC的死亡率为每100,000人年0.73例。与只生育一个孩子的女性相比,生育两个孩子的女性调整后的HR为1.20(95%CI = 0.79 - 1.83),生育三个孩子的女性为1.47(95%CI = 0.95 - 2.29),生育四个或更多孩子的女性为1.68(95%CI = 0.99 - 2.85)。随着生育次数的增加,GC调整后的HR有显著的上升趋势。研究结果表明,生育次数较多的绝经前女性可能会增加GC死亡风险。