Khalis Mohamed, Charbotel Barbara, Chajès Véronique, Rinaldi Sabina, Moskal Aurélie, Biessy Carine, Dossus Laure, Huybrechts Inge, Fort Emmanuel, Mellas Nawfel, Elfakir Samira, Charaka Hafida, Nejjari Chakib, Romieu Isabelle, El Rhazi Karima
Department of Epidemiology, Faculty of Medicine and Pharmacy, Fez, Morocco.
University Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, Lyon, France.
PLoS One. 2018 Jan 16;13(1):e0191333. doi: 10.1371/journal.pone.0191333. eCollection 2018.
Breast cancer is the most common cancer in women worldwide. In the Moroccan context, the role of well-known reproductive factors in breast cancer remains poorly documented. The aim of this study was to explore the relationship between menstrual and reproductive factors and breast cancer risk in Moroccan women in the Fez region.
A case-control study was conducted at the Hassan II University Hospital of Fez between January 2014 and April 2015. A total of 237 cases of breast cancer and 237 age-matched controls were included. Information on sociodemographic characteristics, menstrual and reproductive history, family history of breast cancer, and lifestyle factors was obtained through a structured questionnaire. Conditional logistic regression models were used to estimate odds ratios and 95% confidence intervals for breast cancer by menstrual and reproductive factors adjusted for potential confounders.
Early menarche (OR = 1.60, 95% CI: 1.08-2.38) and nulliparity (OR = 3.77, 95% CI: 1.98-7.30) were significantly related to an increased risk of breast cancer, whereas an early age at first full-term pregnancy was associated with a decreased risk of breast cancer (OR = 0.41, 95% CI: 0.25-0.65).
The results of this study confirm the role of established reproductive factors for breast cancer in Moroccan women. It identified some susceptible groups at high risk of breast cancer. Preventive interventions and screening should focus on these groups as a priority. These results should be confirmed in a larger, multicenter study.
乳腺癌是全球女性中最常见的癌症。在摩洛哥，知名生殖因素在乳腺癌中的作用仍缺乏充分记录。本研究的目的是探讨月经和生殖因素与非斯地区摩洛哥女性乳腺癌风险之间的关系。
2014年1月至2015年4月在非斯哈桑二世大学医院进行了一项病例对照研究。共纳入237例乳腺癌病例和237例年龄匹配的对照。通过结构化问卷获取社会人口学特征、月经和生殖史、乳腺癌家族史以及生活方式因素等信息。采用条件逻辑回归模型，通过对潜在混杂因素进行调整，估计月经和生殖因素导致乳腺癌的比值比及95%置信区间。
初潮早（比值比=1.60，95%置信区间：1.08 - 2.38）和未生育（比值比=3.77，95%置信区间：1.98 - 7.30）与乳腺癌风险增加显著相关，而首次足月妊娠年龄早与乳腺癌风险降低相关（比值比=0.41，95%置信区间：0.25 - 0.65）。
本研究结果证实了既定生殖因素在摩洛哥女性乳腺癌中的作用。它确定了一些乳腺癌高危易感人群。预防性干预和筛查应优先关注这些人群。这些结果应在更大规模的多中心研究中得到证实。
