Bergkvist L, Persson I, Adami H O, Schairer C
Department of Surgery, University Hospital, Uppsala, Sweden.
Int J Epidemiol. 1988 Dec;17(4):732-7. doi: 10.1093/ije/17.4.732.
A matched case-control study was undertaken with the aim of determining the presence of several risk factors for breast and endometrial cancer in a cohort of women--recruited from a defined geographical area of Sweden--who had received at least one oestrogen prescription for menopausal symptoms. A mailed questionnaire was answered by 653 (88.8%) of 735 women sampled from the cohort (cases) and 952 (76.8%) of 1240 women sampled from the background population (controls) and these respondents formed the basis of the analyses. The prevalence rates of oophorectomy and hysterectomy were significantly higher among oestrogen-treated women than in the background population, 10.7% versus 2.6% (odds ratio (OR) = 5.1, 95% confidence interval (Cl) 3.1-8.5) and 19.0% versus 7.3% (OR = 2.7, Cl 1.9-3.8), respectively. Higher theoretical education entailed a more than twofold increase in the risk of receiving oestrogen treatment, compared with women with less than eight years at school. Women who had a first degree relative with breast cancer ran a relative risk of receiving oestrogen therapy of 0.6 (Cl 0.4-0.9) whereas the risk for women with a prior breast biopsy was 1.4 (Cl 1.0-2.1). For all other variables studied, ie diabetes, hypertension, age at menarche, age at first livebirth, nulliparity, age at menopause, height and weight, there were no statistically significant differences between the cohort of oestrogen-treated women and the background population. We conclude that the difference in the prevalence of hysterectomy has to be taken into account when calculating the risk of endometrial cancer in the cohort.(ABSTRACT TRUNCATED AT 250 WORDS)
开展了一项配对病例对照研究,目的是确定在一组女性中乳腺癌和子宫内膜癌的几种风险因素的存在情况。这些女性是从瑞典一个特定地理区域招募的,因更年期症状至少接受过一次雌激素处方治疗。队列中抽取的735名女性(病例组)中有653名(88.8%)回复了邮寄问卷,背景人群中抽取的1240名女性中有952名(76.8%)回复了问卷,这些受访者构成了分析的基础。接受雌激素治疗的女性中卵巢切除术和子宫切除术的患病率显著高于背景人群,分别为10.7%对2.6%(优势比(OR)=5.1,95%置信区间(CI)3.1 - 8.5)和19.0%对7.3%(OR = 2.7,CI 1.9 - 3.8)。与上学年限不足8年的女性相比,受过高等理论教育的女性接受雌激素治疗的风险增加了两倍多。有乳腺癌一级亲属的女性接受雌激素治疗的相对风险为0.6(CI 0.4 - 0.9),而既往有过乳腺活检的女性风险为1.4(CI 1.0 - 2.1)。对于所研究的所有其他变量,即糖尿病、高血压、初潮年龄、首次生育年龄、未生育、绝经年龄、身高和体重,接受雌激素治疗的女性队列与背景人群之间没有统计学上的显著差异。我们得出结论,在计算该队列中子宫内膜癌的风险时,必须考虑子宫切除术患病率的差异。(摘要截短为250字)