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患有不孕症女性的乳腺癌和妇科癌症风险:一项全国范围内基于人群的研究。

The risk of breast and gynecological cancer in women with a diagnosis of infertility: a nationwide population-based study.

机构信息

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77, Stockholm, Sweden.

Department of Oncology-Pathology, Karolinska Institutet and Department of Gynecology and Reproduction, Section of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.

出版信息

Eur J Epidemiol. 2019 May;34(5):499-507. doi: 10.1007/s10654-018-0474-9. Epub 2019 Jan 9.

Abstract

Some studies have suggested that infertility is a risk factor for endometrial, ovarian and breast cancer. The study aimed to create a comprehensive picture of the association between infertility and the risk of ovarian, endometrial and breast cancer, and whether any association could be explained by ovulatory disturbances, endometriosis or nulliparity. In a population-based cohort of 2,882,847 women, cox regression analysis was used to investigate cancer incidence among infertile women. Overall, infertility was associated with a higher incidence rate of ovarian (adjusted hazard ratio [aHR] 1.53, 95% confidence interval [CI] 1.38-1.71) and endometrial cancer (aHR 1.25, 95% CI 1.11-1.40), but not of breast cancer (aHR 0.96, 95% CI 0.92-1.01). Ovarian cancer incidence was higher in women diagnosed with endometriosis, and in nulliparous women with ovulatory disturbances, compared to women with none of the diagnoses. Endometrial cancer incidence was higher in women with ovulatory disturbances, but not in women with endometriosis. These findings suggest that infertility could have long-term consequences of importance to physicians and public health workers.

摘要

一些研究表明,不孕是子宫内膜癌、卵巢癌和乳腺癌的一个风险因素。本研究旨在全面了解不孕与卵巢癌、子宫内膜癌和乳腺癌风险之间的关系,以及排卵障碍、子宫内膜异位症或未婚是否可以解释任何关联。在一项基于人群的 2882847 名女性队列研究中,使用 Cox 回归分析调查了不孕女性的癌症发病率。总体而言,不孕与卵巢癌(调整后的危险比[aHR]1.53,95%置信区间[CI]1.38-1.71)和子宫内膜癌(aHR 1.25,95%CI 1.11-1.40)的发病率较高,但与乳腺癌(aHR 0.96,95%CI 0.92-1.01)无关。与无这些诊断的女性相比,患有子宫内膜异位症和排卵障碍的未婚女性的卵巢癌发病率更高。与无排卵障碍的女性相比,患有排卵障碍的女性的子宫内膜癌发病率更高。这些发现表明,不孕可能对医生和公共卫生工作者具有重要的长期影响。

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