Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China; State Key Laboratory of Oncology in South China & Collaborative Innovation Center for Cancer Medicine & Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Exponent, Inc., Health Sciences Practice, Menlo Park, CA, USA; Stanford Cancer Institute, Stanford, CA, USA.
Oral Oncol. 2019 Jan;88:102-108. doi: 10.1016/j.oraloncology.2018.11.025. Epub 2018 Nov 23.
Nasopharyngeal carcinoma (NPC) incidence exhibits a remarkable sex disparity, with higher risk among males. Whether this pattern can be partly explained by female reproductive history is unclear.
A population-based case-control study of NPC was conducted in southern China between 2010 and 2014, including 674 histopathologically verified female NPC cases and 690 female controls randomly selected from population-based registries. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression after adjusting for potential confounders.
Women who had 3, 4, or ≥5 pregnancies compared with 2 pregnancies were at significantly increased risk for NPC (ORs 1.56, 1.45 and 1.88, respectively). History of deliveries was similarly associated with a greater risk of NPC. These positive associations were more prominent in women who were younger than 50 years, had less than 10 years of education, or were white-collar workers. Increasing time since menopause was associated with a diminished NPC risk (P = 0.010). Women more than 15 years after menopause had a 0.35-fold (95% CI: 0.16-0.75) NPC risk compared with those 0-3 years after menopause.
Contrary to our hypothesis, a history of pregnancy or delivery increased the risk of NPC and the risk decreased with increasing time since menopause. However, the non-linear relationship and no consistent risk patterns across strata indicate that the observed associations are unlikely to be causal, and may at least partially be ascribed to residual confounding by socioeconomic factors.
鼻咽癌（NPC）的发病率存在显著的性别差异，男性发病率更高。这种模式是否部分可以由女性生殖史来解释尚不清楚。
在中国南方进行了一项基于人群的 NPC 病例对照研究，纳入了 2010 年至 2014 年间经组织病理学证实的 674 例女性 NPC 病例和 690 例从人群登记处随机选择的女性对照。使用 logistic 回归调整潜在混杂因素后，估计比值比（ORs）和 95%置信区间（CIs）。
与 2 次妊娠相比，有 3 次、4 次或≥5 次妊娠的女性患 NPC 的风险显著增加（ORs 分别为 1.56、1.45 和 1.88）。分娩史也与 NPC 的发病风险呈正相关。这些阳性关联在年龄小于 50 岁、受教育程度低于 10 年或从事白领工作的女性中更为明显。绝经后时间的增加与 NPC 风险的降低相关（P=0.010）。绝经后超过 15 年的女性 NPC 发病风险是绝经后 0-3 年女性的 0.35 倍（95%CI：0.16-0.75）。
与我们的假设相反，妊娠或分娩史增加了 NPC 的发病风险，并且随着绝经后时间的增加，风险降低。然而，非线性关系和不同分层之间没有一致的风险模式表明，观察到的关联不太可能是因果关系，并且可能至少部分归因于社会经济因素的残余混杂。
