Bethea Traci N, Palmer Julie R, Adams-Campbell Lucile L, Rosenberg Lynn
Slone Epidemiology Center, Boston University, 1010 Commonwealth Avenue, Boston, MA, 02215, USA.
Department of Medicine, Boston University School of Medicine, 715 Albany St. E-113, Boston, MA, 02118, USA.
Cancer Causes Control. 2017 May;28(5):385-391. doi: 10.1007/s10552-016-0840-4. Epub 2016 Dec 27.
Extensive data in White women have linked oral contraceptive use, tubal ligation, and parity to reduced risk of ovarian cancer; results on postmenopausal female hormone use are mixed. Few studies, all of which are case-control studies, have been undertaken among Black women. The aim of the present study was to prospectively assess associations of reproductive factors and exogenous hormones with ovarian cancer among Black women.
During follow-up from 1995 to 2013 in the Black Women's Health Study, a prospective cohort study, 115 incident cases of ovarian cancer were identified. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the relation of the factors of interest to risk of ovarian cancer, with control for covariates.
Oral contraceptive use was inversely associated with ovarian cancer risk: The HR for ≥10 years of use relative to <1 year was 0.50 (95% CI 0.30-0.98). For postmenopausal female hormone use, the HRs for ever use of estrogen with progestin and of estrogen alone were 1.37 (0.73-2.55) and 1.66 (0.90-3.07), respectively. The HRs for parity and tubal ligation were below 1.0, but were not statistically significant.
Overall, the findings indicate that the relation of reproductive factors and exogenous hormone use to risk of ovarian cancer is similar among Black and White women. The results on estrogen-only supplements and estrogen with progestin supplements add to evidence from Whites, indicating that use of hormone supplements may be associated with increased risk of ovarian cancer.
白人女性的大量数据表明,口服避孕药、输卵管结扎和生育与卵巢癌风险降低有关;绝经后使用女性激素的结果则好坏参半。针对黑人女性开展的研究很少,且均为病例对照研究。本研究的目的是前瞻性评估黑人女性生殖因素和外源性激素与卵巢癌之间的关联。
在黑人女性健康研究(一项前瞻性队列研究)1995年至2013年的随访期间,共确定了115例卵巢癌新发病例。采用Cox比例风险模型计算感兴趣因素与卵巢癌风险之间关系的风险比(HR)和95%置信区间(CI),并对协变量进行控制。
口服避孕药与卵巢癌风险呈负相关:使用≥10年相对于使用<1年的HR为0.50(95%CI 0.30 - 0.98)。对于绝经后使用女性激素,曾经使用雌激素加孕激素和单独使用雌激素的HR分别为1.37(0.73 - 2.55)和1.66(0.90 - 3.07)。生育和输卵管结扎的HR均低于1.0,但无统计学意义。
总体而言,研究结果表明,黑人女性和白人女性在生殖因素和外源性激素使用与卵巢癌风险的关系方面相似。仅使用雌激素补充剂和使用雌激素加孕激素补充剂的结果进一步补充了白人的证据,表明使用激素补充剂可能与卵巢癌风险增加有关。