McNamara Chrissy, Abbott Sarah E, Bandera Elisa V, Qin Bo, Peres Lauren C, Camacho Fabian, Moorman Patricia G, Alberg Anthony J, Barnholtz-Sloan Jill S, Bondy Melissa, Cote Michele L, Funkhouser Ellen, Peters Edward S, Schwartz Ann G, Schildkraut Joellen M, Terry Paul
Georgia Comprehensive Cancer Registry, Georgia Department of Public Health, Atlanta, GA, USA.
Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
Cancer Causes Control. 2017 Oct;28(10):1033-1041. doi: 10.1007/s10552-017-0943-6. Epub 2017 Sep 4.
Tubal ligation has been associated with reduced risk of epithelial ovarian cancer (EOC) in studies of primarily white women, but less is known about the association in African American (AA) women. We sought to evaluate the associations among 597 invasive ovarian cancer cases and 742 controls of AA descent recruited from the African American Cancer Epidemiology Study, a population-based case-control study in 11 geographical areas in the US.
Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for potentially confounding factors.
An inverse association between tubal ligation and EOC was observed that was not statistically significant (OR 0.88, 95% CI 0.68-1.14). However, an inverse association with EOC risk was observed among women who had a tubal ligation at age 35 years or older (OR 0.64; 95% CI 0.41-0.98), but not among those who had a tubal ligation before age 35 (OR 0.98; 95% CI 0.74-1.29) (p for interaction = 0.08). The association also varied considerably by tumor subtype. A strong inverse association was observed for endometrioid tumors (OR 0.31, 95% CI 0.14-0.70), whereas associations with mucinous (OR 0.87, 95% CI 0.36-2.12) and serous (OR 0.94, 95% CI 0.71-1.24) tumors were weaker and not statistically significant. A statistically non-significant positive association for clear cell tumors (OR 1.84, 95% CI 0.58-5.82) was based on a low number of cases.
Our findings show that tubal ligation may confer a reduced risk for EOC among AA women that is comparable to the associations that have been previously observed in primarily white populations.
在主要针对白人女性的研究中，输卵管结扎与上皮性卵巢癌（EOC）风险降低有关，但对于非裔美国（AA）女性的这种关联了解较少。我们试图评估从非裔美国癌症流行病学研究中招募的597例侵袭性卵巢癌病例和742例AA血统对照之间的关联，该研究是一项在美国11个地理区域进行的基于人群的病例对照研究。
使用多变量逻辑回归模型来估计优势比（OR）和针对潜在混杂因素进行调整的95%置信区间（CI）。
观察到输卵管结扎与EOC之间存在负相关，但无统计学意义（OR 0.88，95% CI 0.68 - 1.14）。然而，在35岁及以上进行输卵管结扎的女性中观察到与EOC风险存在负相关（OR 0.64；95% CI 0.41 - 0.98），而在35岁之前进行输卵管结扎的女性中未观察到这种关联（OR 0.98；95% CI 0.74 - 1.29）（交互作用p = 0.08）。这种关联在肿瘤亚型之间也有很大差异。对于子宫内膜样肿瘤观察到强烈的负相关（OR 0.31，95% CI 0.14 - 0.70），而与黏液性（OR 0.87，95% CI 0.36 - 2.12）和浆液性（OR 0.94，95% CI 0.71 - 1.24）肿瘤的关联较弱且无统计学意义。基于病例数较少，透明细胞肿瘤的统计学无显著正相关（OR 1.84，95% CI
