Lin Li-Te, Hu Li-Yu, Tang Pei-Ling, Tsui Kuan-Hao, Cheng Jiin-Tsuey, Huang Wei-Chun, Chang Hong-Tai
a Department of Obstetrics and Gynecology , Kaohsiung Veterans General Hospital , Kaohsiung , Taiwan.
b Department of Biological Science , National Sun Yat-sen University , Kaohsiung , Taiwan.
Hypertens Pregnancy. 2017 May;36(2):138-144. doi: 10.1080/10641955.2016.1258411. Epub 2017 Jan 19.
Previous studies investigating the relationship between pregnancy-induced hypertension (PIH) and breast cancer risk have yielded inconsistent results. Unlike numerous Western studies, studies have reported that PIH may be a risk factor for breast cancer in Western Asian women. To confirm these results, we designed a retrospective population-based cohort study to assess the relationship between PIH and subsequent risk for breast cancer in Taiwan.
Patients with newly diagnosed PIH were selected from the Taiwan National Health Insurance Research Database (NHIRD), and a 1:4 matched cohort of women without PIH based on age and the year of delivery was randomly selected from the same database as the comparison group. The incidence of new-onset breast cancer was assessed in both cohorts.
Among the 23.3 million individuals registered in the NHIRD, 26,638 patients with PIH and 106,552 matched controls were identified. The incidence rate of breast cancer was higher in patients with PIH than in the matched controls (incidence rate ratio = 1.09, 95% confidence interval [CI] = 1.09-1.10, p < 0.0001). However, the Kaplan-Meier analysis revealed a similar cumulative incidence rate of breast cancer between the PIH and comparison cohorts (log-rank p = 0.4303). Moreover, results from a multivariate analysis indicated that PIH was not a statistically significant independent risk factor for breast cancer (adjusted hazard ratio = 1.10, 95% CI = 0.87-1.39, p = 0.4247).
The present study demonstrated no significant temporal relationship between PIH and risk for subsequent breast cancer in Eastern Asian women.
先前关于妊娠高血压(PIH)与乳腺癌风险之间关系的研究结果并不一致。与众多西方研究不同,有研究报告称PIH可能是西亚女性患乳腺癌的一个风险因素。为了证实这些结果,我们设计了一项基于人群的回顾性队列研究,以评估台湾地区PIH与后续患乳腺癌风险之间的关系。
从台湾国民健康保险研究数据库(NHIRD)中选取新诊断为PIH的患者,并从同一数据库中随机选取1:4匹配的无PIH女性队列作为对照组,匹配因素为年龄和分娩年份。评估两个队列中新发乳腺癌的发病率。
在NHIRD登记的2330万人中,确定了26638例PIH患者和106552例匹配的对照组。PIH患者的乳腺癌发病率高于匹配的对照组(发病率比=1.09,95%置信区间[CI]=1.09-1.10,p<0.0001)。然而,Kaplan-Meier分析显示PIH队列和对照组之间乳腺癌的累积发病率相似(对数秩检验p=0.4303)。此外,多变量分析结果表明PIH不是乳腺癌的统计学显著独立风险因素(调整后风险比=1.10,95%CI=0.87-1.39,p=0.4247)。
本研究表明东亚女性中PIH与后续患乳腺癌风险之间无显著的时间关系。