Liu Rong, Kitamura Yuri, Kitamura Tetsuhisa, Sobue Tomotaka, Sado Junya, Sugawara Yumi, Matsuo Keitaro, Nakayama Tomio, Tsuji Ichiro, Ito Hidemi, Suzuki Takaichiro, Katanoda Kota, Tominaga Suketami
Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita.
Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Public Health, Sendai.
Medicine (Baltimore). 2019 Dec;98(51):e18315. doi: 10.1097/MD.0000000000018315.
The incidence of breast cancer among Japanese women is substantially increasing. This study evaluated the effects of reproductive and lifestyle factors with respect to breast cancer overall and separately among pre- and postmenopausal women using data from the Three-Prefecture Cohort Study of Japan.A total of 33,410 women aged 40 to 79 years completed a self-administered questionnaire, which included items about menstrual and reproductive history and other lifestyle factors. The follow-up period was from 1984 to 1992 in Miyagi and 1985 to 2000 in Aichi Prefectures. We used Cox proportional hazards regression models to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) after adjusting for confounding factors.After 9.8 mean years of follow-up, 287 cases of breast cancer were recorded. In the overall analysis, later menarche (≥16 years) and parity were significantly associated with a decreased risk of breast cancer, with HRs of 0.69 (95% CI 0.48-0.99) and 0.72 (95% CI 0.52-0.99), respectively. Further, there was a significant decline in the risk of breast cancer with increasing number of birth among parous women (P for trend = .010). On the contrary, a family history of breast cancer in the mother was significantly associated with an increased risk of breast cancer (HR 3.22, 95% CI 1.52-6.84). Analyses based on menopausal status at baseline indicated that height (≥160 cm) and weight (≥65 kg) were significantly associated with an increased risk of postmenopausal breast cancer, with HRs of 1.34 (95% CI 0.72-2.50) and 3.13 (95% CI 1.75-5.60), respectively. Risk associated with BMI significantly differs by menopausal status.Our findings suggest the important role of reproductive factors in the development of breast cancer in Japanese women; however, body mass index (BMI) may have different effects on breast cancer in Japanese women compared with western women.
日本女性乳腺癌的发病率正在大幅上升。本研究利用日本三县队列研究的数据,评估了生殖因素和生活方式因素对乳腺癌总体的影响,以及在绝经前和绝经后女性中的单独影响。共有33410名年龄在40至79岁之间的女性完成了一份自我管理问卷,其中包括月经和生殖史以及其他生活方式因素的相关项目。宫城县的随访期为1984年至1992年,爱知县的随访期为1985年至2000年。我们使用Cox比例风险回归模型在调整混杂因素后估计风险比(HRs)和95%置信区间(CIs)。
经过平均9.8年的随访,记录了287例乳腺癌病例。在总体分析中,初潮较晚(≥16岁)和生育次数与乳腺癌风险降低显著相关,HR分别为0.69(95%CI 0.48-0.99)和0.72(95%CI 0.52-0.99)。此外,经产妇生育次数增加,乳腺癌风险显著下降(趋势P值 = 0.010)。相反,母亲有乳腺癌家族史与乳腺癌风险增加显著相关(HR 3.22,95%CI 1.52-6.84)。基于基线绝经状态的分析表明,身高(≥160 cm)和体重(≥65 kg)与绝经后乳腺癌风险增加显著相关,HR分别为1.34(95%CI 0.72-2.50)和3.13(95%CI 1.75-5.60)。与BMI相关的风险因绝经状态而异。
我们的研究结果表明生殖因素在日本女性乳腺癌发病中起着重要作用;然而,与西方女性相比,体重指数(BMI)对日本女性乳腺癌可能有不同影响。