Paganini-Hill A, Ross R K, Henderson B E
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90033-0800.
Br J Cancer. 1989 Mar;59(3):445-7. doi: 10.1038/bjc.1989.91.
5,160 non-hysterectomised women aged 44-100 years completed a health survey questionnaire as part of a longitudinal study of a southern California retirement community begun in June 1981. As of 1 January 1987, 50 incident cancers of the endometrium had occurred among these women, who had contributed 23,786 years of follow-up. Women who had used oestrogen replacement therapy had a relative risk of endometrial cancer of 10 compared to women who had never used oestrogens (P less than 0.0001). Risk increased with increasing duration of use (chi 2 test for trend = 50.60, P less than 0.0001); women who had used oestrogens for 15 or more years had a relative risk of 20 (95% C.I. = 7.2, 54) compared to non-users. While current and recent users (i.e. those who had used oestrogen within one year of the initial survey) had the greatest risk (RR = 25, 95% C.I. = 9.2, 69), women who had last used oestrogens 15 or more years ago still had a significantly increased risk (RR = 5.8, 95% C.I. = 2.0, 17). No other variable studied had a major effect on risk, except smoking. Women who smoked at the time of menopause had a significantly reduced risk of disease (RR = 0.38, P = 0.005), which was essentially unchanged after adjustment for oestrogen use.
作为1981年6月开始的一项南加州退休社区纵向研究的一部分，5160名年龄在44至100岁之间未接受子宫切除术的女性完成了一份健康调查问卷。截至1987年1月1日，这些女性中有50例子宫内膜癌发病，她们共提供了23786人年的随访数据。与从未使用过雌激素的女性相比，使用过雌激素替代疗法的女性患子宫内膜癌的相对风险为10（P<0.0001）。风险随着使用时间的延长而增加（趋势的卡方检验=50.60，P<0.0001）；与未使用者相比，使用雌激素15年或更长时间的女性相对风险为20（95%置信区间=7.2，54）。虽然当前使用者和近期使用者（即在初次调查后一年内使用过雌激素的人）风险最高（RR=25，95%置信区间=9.2，69），但最后一次使用雌激素在15年或更长时间以前的女性风险仍显著增加（RR=5.8，95%置信区间=2.0，17）。除吸烟外，研究的其他变量对风险均无重大影响。绝经时吸烟的女性患该病的风险显著降低（RR=0.38，P=0.005），在调整雌激素使用情况后基本不变。
