母乳喂养与子宫内膜癌风险：来自子宫内膜癌联盟流行病学的分析。
Breastfeeding and Endometrial Cancer Risk: An Analysis From the Epidemiology of Endometrial Cancer Consortium.
作者信息
Jordan Susan J, Na Renhua, Johnatty Sharon E, Wise Lauren A, Adami Hans Olov, Brinton Louise A, Chen Chu, Cook Linda S, Dal Maso Luigino, De Vivo Immaculata, Freudenheim Jo L, Friedenreich Christine M, La Vecchia Carlo, McCann Susan E, Moysich Kirsten B, Lu Lingeng, Olson Sara H, Palmer Julie R, Petruzella Stacey, Pike Malcolm C, Rebbeck Timothy R, Ricceri Fulvio, Risch Harvey A, Sacerdote Carlotta, Setiawan Veronica Wendy, Sponholtz Todd R, Shu Xiao Ou, Spurdle Amanda B, Weiderpass Elisabete, Wentzensen Nicolas, Yang Hannah P, Yu Herbert, Webb Penelope M
机构信息
QIMR Berghofer Medical Research Institute, and the University of Queensland, School of Public Health, Brisbane, Australia; the Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland; the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; the Department of Internal Medicine and UNM Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico; the Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada; the Unit of Cancer Epidemiology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; the Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York; the Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy; Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York; Yale School of Public Health, New Haven, Connecticut; the Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York; Slone Epidemiology Center, Boston University, Boston, Massachusetts; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Harvard TH Chan School of Public Health and Dana Farber Cancer Institute, Boston, Massachusetts; the Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy; the Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Centre, Vanderbilt University School of Medicine, Nashville, Tennessee; the Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; the Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland; the Department of Community Medicine, University of Tromsø, and the Arctic University of Norway, Tromsø, Norway; and the Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
出版信息
Obstet Gynecol. 2017 Jun;129(6):1059-1067. doi: 10.1097/AOG.0000000000002057.
OBJECTIVE
To investigate the association between breastfeeding and endometrial cancer risk using pooled data from 17 studies participating in the Epidemiology of Endometrial Cancer Consortium.
METHODS
We conducted a meta-analysis with individual-level data from three cohort and 14 case-control studies. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the association between breastfeeding and risk of endometrial cancer using multivariable logistic regression and pooled using random-effects meta-analysis. We investigated between-study heterogeneity with I and Q statistics and metaregression.
RESULTS
After excluding nulliparous women, the analyses included 8,981 women with endometrial cancer and 17,241 women in a control group. Ever breastfeeding was associated with an 11% reduction in risk of endometrial cancer (pooled OR 0.89, 95% CI 0.81-0.98). Longer average duration of breastfeeding per child was associated with lower risk of endometrial cancer, although there appeared to be some leveling of this effect beyond 6-9 months. The association with ever breastfeeding was not explained by greater parity and did not vary notably by body mass index or histologic subtype (grouped as endometrioid and mucinous compared with serous and clear cell).
CONCLUSION
Our findings suggest that reducing endometrial cancer risk can be added to the list of maternal benefits associated with breastfeeding. Ongoing promotion, support, and facilitation of this safe and beneficial behavior might therefore contribute to the prevention of this increasingly common cancer.
目的
利用参与子宫内膜癌流行病学联盟的17项研究的汇总数据，调查母乳喂养与子宫内膜癌风险之间的关联。
方法
我们对来自3项队列研究和14项病例对照研究的个体水平数据进行了荟萃分析。使用多变量逻辑回归估计母乳喂养与子宫内膜癌风险之间关联的研究特异性比值比（OR）和95%置信区间（CI），并采用随机效应荟萃分析进行汇总。我们用I²和Q统计量以及元回归研究了研究间的异质性。
结果
排除未生育女性后，分析纳入了8981例子宫内膜癌女性和17241例对照组女性。曾经母乳喂养与子宫内膜癌风险降低11%相关（汇总OR为0.89，95%CI为0.81 - 0.98）。每个孩子的平均母乳喂养时间越长，子宫内膜癌风险越低，尽管在6 - 9个月之后这种效应似乎有所平缓。曾经母乳喂养与子宫内膜癌风险的关联不能用更高的生育次数来解释，并且在体重指数或组织学亚型（分为子宫内膜样和黏液性与浆液性和透明细胞性相比）方面没有显著差异。
结论
我们的研究结果表明，降低子宫内膜癌风险可被添加到与母乳喂养相关的母体益处清单中。因此，持续推广、支持和促进这种安全有益的行为可能有助于预防这种日益常见的癌症。
Zotero 插件