Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
BJOG. 2017 Jan;124(1):143-149. doi: 10.1111/1471-0528.13949. Epub 2016 Feb 29.
To determine the incidence and occupational variation of granulosa cell tumours (GCTs) in Finland, Iceland, Norway and Sweden over a 60-year period, 1953-2012.
A longitudinal cohort study.
Finland, Iceland, Norway and Sweden and a total of 249 million women over a 60-year period (1953-2012). The NOCCA (Nordic Occupational Cancer Study) included 6.4 million women with 776 incident GCT cases diagnosed until the end of follow up.
Incidence rates were calculated from the national cancer registries and compared using quasi-Poisson regression models. Occupation-specific standardised incidence ratios (SIRs) were calculated from the Nordic Occupational Cancer (NOCCA) database.
Incidence rates and standardised incidence ratios.
The age-adjusted (World Standard) incidence rates remained quite constant: about 0.6-0.8 per 100 000 for most of the study period. The age-specific incidence was highest at 50-64 years of age. There were no occupations with significantly increased risk of GCT. Major changes in the use of oral contraceptives, postmenopausal hormonal therapy, fertility rate and lifestyle in general during the study period and among different occupational categories do not appear to have a marked effect on the incidence of GCT.
Our findings support the concept of GCT as a primarily sporadic, not exposure-related, cancer.
The Nordic incidence rates of GCTs show stability over time and among different occupational categories.
在 1953 年至 2012 年的 60 年间,确定芬兰、冰岛、挪威和瑞典的颗粒细胞瘤(GCT)的发病率和职业差异。
纵向队列研究。
芬兰、冰岛、挪威和瑞典,60 年间共有 2.49 亿女性(1953-2012 年)。NOCCA(北欧职业癌症研究)纳入了 640 万女性,随访结束时共诊断出 776 例 GCT 病例。
发病率根据国家癌症登记处计算,并使用拟泊松回归模型进行比较。职业特异性标准化发病比(SIR)根据北欧职业癌症(NOCCA)数据库计算。
发病率和标准化发病比。
年龄调整(世界标准)发病率保持相当稳定:研究期间大部分时间约为 0.6-0.8/10 万。年龄特异性发病率在 50-64 岁最高。没有职业的 GCT 风险显著增加。研究期间和不同职业类别中,口服避孕药、绝经后激素治疗、生育率和生活方式的重大变化似乎对 GCT 的发病率没有明显影响。
我们的发现支持 GCT 主要是偶发性的、与暴露无关的癌症的概念。
北欧 GCT 的发病率在时间和不同职业类别中保持稳定。