Chaveepojnkamjorn Wisit, Pichainarong Natchaporn, Thotong Rungsinoppadol, Sativipawee Pratana, Pitikultang Supachai
Department of Epidemiology, Faculty of Public Health, Mahidol University, Ratchathewi, Bangkok, Thailand. Email:
Asian Pac J Cancer Prev. 2017 May 1;18(5):1429-1433. doi: 10.22034/APJCP.2017.18.5.1429.
Background: Breast cancer (BC) is an important issue both in medicine and public health as it is the leading malignancy with high incidence and mortality among women worldwide. The objective of this research was to determine the associations of BC with oral contraceptive (OC) use among Thai premenopausal women (TPW). Materials and Methods: A case-control study was conducted among TPW attending the National Cancer Institute, with 257 cases and 257 controls in 2013-2014. Cases and controls were matched by age (± 5 years), residential area and duration of attendance. Data were collected with a questionnaire that comprised 2 sections: part 1 socio-demographic characteristics, and part 2 health risk behavior and reproductive factors. The obtained data were analyzed using descriptive and analytic statistics with a computerized statistical package. Results: The study participants were mainly 40-44 years old (60 %) with an average age of 39 years. The major BC type was invasive ductal carcinoma (91.8%). Multiple unconditional logistic regression analysis, controlling for possible confounding factors, revealed that TPW with OC use increased the risk of BC by a factor of over 3 times (ORadj=3.39, 95%CI =1.99-5.75). In addition, the greater the duration of OC, the greater the risk (ORadj 6-10 yrs=3.91, 95%CI = 1.99-7.64, ORadj >10 yrs=4.23, 95%CI = 2.05-8.71). Conclusions: From our findings, a surveillance system of cancer risk with OC use should be conducted, accompanied by an exercise promotion campaign among risk groups, providing information and counseling for physical exercise and physical activities, weight control and basic adjustment for a healthy lifestyle to reduce BC.
乳腺癌在医学和公共卫生领域都是一个重要问题，因为它是全球女性中发病率和死亡率最高的主要恶性肿瘤。本研究的目的是确定泰国绝经前女性（TPW）中乳腺癌与口服避孕药（OC）使用之间的关联。材料与方法：在泰国国家癌症研究所就诊的TPW中进行了一项病例对照研究，2013 - 2014年有257例病例和257例对照。病例和对照按年龄（±5岁）、居住地区和就诊时间进行匹配。通过一份包含两个部分的问卷收集数据：第1部分是社会人口学特征，第2部分是健康风险行为和生殖因素。使用计算机统计软件包对获得的数据进行描述性和分析性统计分析。结果：研究参与者主要为40 - 44岁（60%），平均年龄39岁。主要的乳腺癌类型是浸润性导管癌（91.8%）。在控制了可能的混杂因素后进行的多因素无条件逻辑回归分析显示，使用OC的TPW患乳腺癌的风险增加了3倍多（校正比值比=3.39，95%置信区间=1.99 - 5.75）。此外，OC使用时间越长，风险越高（校正比值比6 - 10年=3.91，95%置信区间=1.99 - 7.64，校正比值比>10年=4.23，95%置信区间=2.05 - 8.71）。结论：根据我们的研究结果，应建立一个针对使用OC的癌症风险监测系统，并在风险人群中开展运动促进活动，提供有关体育锻炼和身体活动、体重控制以及健康生活方式基本调整的信息和咨询，以降低乳腺癌的发生。
