Birmann Brenda M, Barnard Mollie E, Bertrand Kimberly A, Bao Ying, Crous-Bou Marta, Wolpin Brian M, De Vivo Immaculata, Tworoger Shelley S
Brenda M. Birmann, Ying Bao, Marta Crous-Bou, Immaculata De Vivo, and Shelley S. Tworoger are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Mollie E. Barnard is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston. Kimberly A. Bertrand is with the Slone Epidemiology Center, Boston University, Boston. Brian M. Wolpin is with the Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School.
Am J Public Health. 2016 Sep;106(9):1608-15. doi: 10.2105/AJPH.2016.303337. Epub 2016 Jul 26.
To review the contributions of the Nurses' Health Study (NHS) to epidemiologic knowledge of endometrial, ovarian, pancreatic, and hematologic cancers.
We reviewed selected NHS publications from 1976 to 2016, including publications from consortia and other pooled studies.
NHS studies on less common cancers have identified novel risk factors, such as a reduced risk of endometrial cancer in women of advanced age at last birth, and have clarified or prospectively confirmed previously reported associations, including an inverse association between tubal ligation and ovarian cancer. Through biomarker research, the NHS has furthered understanding of the pathogenesis of rare cancers, such as the role of altered metabolism in pancreatic cancer risk and survival. NHS investigations have also demonstrated the importance of the timing of exposure, such as the finding of a positive association of early life body fatness, but not of usual adult body mass index, with non-Hodgkin lymphoma risk.
Evidence from the NHS has informed prevention strategies and contributed to improved survival from less common but often lethal malignancies, including endometrial, ovarian, pancreatic, and hematologic cancers.
回顾护士健康研究（NHS）对子宫内膜癌、卵巢癌、胰腺癌和血液系统癌症流行病学知识的贡献。
我们回顾了1976年至2016年NHS的部分出版物，包括来自合作团体和其他汇总研究的出版物。
NHS对罕见癌症的研究确定了新的风险因素，例如最后一次生育时年龄较大的女性患子宫内膜癌的风险降低，并阐明或前瞻性地证实了先前报道的关联，包括输卵管结扎与卵巢癌之间的负相关。通过生物标志物研究，NHS进一步加深了对罕见癌症发病机制的理解，例如代谢改变在胰腺癌风险和生存中的作用。NHS的调查还证明了暴露时间的重要性，例如发现早年体脂与非霍奇金淋巴瘤风险呈正相关，而成年期通常的体重指数与非霍奇金淋巴瘤风险无此关联。
NHS的证据为预防策略提供了依据，并有助于提高包括子宫内膜癌、卵巢癌、胰腺癌和血液系统癌症在内的罕见但往往致命的恶性肿瘤的生存率。
