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偏头痛与乳腺癌风险的相关性:一项基于人群的队列研究和文献综述。

Association Between Migraine and Breast Cancer Risk: A Population-Based Cohort Study and Literature Review.

机构信息

Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.

出版信息

J Womens Health (Larchmt). 2018 Dec;27(12):1499-1507. doi: 10.1089/jwh.2018.6929. Epub 2018 Sep 5.

Abstract

Previous case-control studies have suggested that women with migraine have lower risk of developing breast cancer, but conflicting results were noted in cohort studies. We investigated the association between migraine and breast cancer incidence in a nationwide population-based cohort study. We identified 25,606 women with migraine between 2000 and 2013 from the National Health Insurance Research Database in Taiwan. Each migraineur was randomly frequency matched with four women without migraine by age and index year of migraine diagnosis. Cox's proportional hazard regression analysis was performed to estimate the association between migraine on the risk of developing breast cancer. With a mean follow-up of 7.3 years, 234 and 978 breast malignancies occurred in the migraine cohort and matched cohort, respectively. Migraine was not associated with the risk of breast cancer (adjusted hazard ratio = 1.03, 95% confidence interval = 0.89-1.21). Among women with migraine, independent risk factors for breast cancer included older age, alcohol-related illness, and receipt of a greater number of breast cancer screening examinations, and independent protective factors included the use of antihypertensive agents, statins, and nonsteroidal anti-inflammatory drugs. Further analyses indicated that women with ≥4 medical visits for migraine per year had a significantly greater risk of breast cancer than the matched cohort. Migraine was not associated with a decreased risk of developing breast cancer among Taiwanese women. Further prospective studies on other geographic populations or on the association between migraine frequency and the risk of developing breast cancer are warranted to validate our findings.

摘要

先前的病例对照研究表明,偏头痛女性罹患乳腺癌的风险较低,但队列研究得出了相互矛盾的结果。我们在一项基于全国人群的队列研究中调查了偏头痛与乳腺癌发病之间的关联。我们从台湾全民健康保险研究数据库中确定了 2000 年至 2013 年间患有偏头痛的 25606 名女性。每位偏头痛患者均通过偏头痛诊断的年龄和指数年份与 4 名无偏头痛的女性进行随机频数匹配。采用 Cox 比例风险回归分析来评估偏头痛与乳腺癌发病风险之间的关系。在平均 7.3 年的随访期间,偏头痛组和匹配组分别发生了 234 例和 978 例乳腺癌恶性肿瘤。偏头痛与乳腺癌风险无关(调整后的危险比=1.03,95%置信区间=0.89-1.21)。在偏头痛女性中,乳腺癌的独立危险因素包括年龄较大、与酒精相关的疾病以及接受了更多的乳腺癌筛查检查,独立保护因素包括使用抗高血压药物、他汀类药物和非甾体抗炎药。进一步的分析表明,每年偏头痛就诊次数≥4 次的女性罹患乳腺癌的风险明显高于匹配组。偏头痛与台湾女性罹患乳腺癌的风险降低无关。有必要对其他地理人群或偏头痛发作频率与乳腺癌发病风险之间的关联进行进一步的前瞻性研究,以验证我们的研究结果。

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