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未生育女性中流产与患乳腺癌风险之间无关联:一项荟萃分析的证据。

No association between abortion and risk of breast cancer among nulliparous women: Evidence from a meta-analysis.

作者信息

Tong Huazhang, Wu Yifan, Yan Yin, Dong Yonghai, Guan Xihong, Liu Yun, Lu ZhiHui

机构信息

Oncology Department, Jiangxi Provincial People's Hospital Affiliated to Nanchang University.

Medical College of Nanchang University.

出版信息

Medicine (Baltimore). 2020 May;99(19):e20251. doi: 10.1097/MD.0000000000020251.

Abstract

BACKGROUND

Various epidemiological studies have demonstrated the association between abortion and risk of breast cancer among nulliparous women; however, results remain inconclusive. This meta-analysis assessed the association based on previous studies.

METHODS

PubMed, EMBase, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang databases were searched for relevant articles until February 2018. In this meta-analysis, fixed-effects models were used to estimate the combined effect size and the corresponding 95% confidence interval (CI). All statistical data were analyzed using STATA 12.0.

RESULTS

A total of 14 articles consisting of 6 cohort studies and 8 case-control studies were included in this review. All articles were of high quality, as determined based on the Newcastle Ottawa Scale assessment. The combined risk ratio (RR) indicated no significant association between abortion and breast cancer among nulliparous women (RR = 1.023, 95%CI = 0.938-1.117; Z = 0.51, P = .607). Subgroup analyses revealed no significant associations between risk of breast cancer and induced abortion or between risk of breast cancer and spontaneous abortion (SA) among nulliparous women (RR = 1.008, 95% CI = 0.909-1.118 and RR = 1.062, 95%CI = 0.902-1.250, respectively). Neither 1 nor >2 abortions increased the risk of breast cancer among nulliparous women. Sensitivity analysis showed that our results were reliable and stable.

CONCLUSION

Current evidence based on epidemiological studies showed no association between abortion and risk of breast cancer among nulliparous women.

摘要

背景

多项流行病学研究表明,未生育女性的流产与乳腺癌风险之间存在关联;然而,结果仍无定论。本荟萃分析基于既往研究评估了这种关联。

方法

检索PubMed、EMBase、中国知网、维普数据库和万方数据库,查找截至2018年2月的相关文章。在本荟萃分析中,采用固定效应模型估计合并效应量及相应的95%置信区间(CI)。所有统计数据均使用STATA 12.0进行分析。

结果

本综述共纳入14篇文章,其中包括6项队列研究和8项病例对照研究。根据纽卡斯尔渥太华量表评估,所有文章质量均较高。合并风险比(RR)表明,未生育女性的流产与乳腺癌之间无显著关联(RR = 1.023,95%CI = 0.938 - 1.117;Z = 0.51,P = 0.607)。亚组分析显示,未生育女性的乳腺癌风险与人工流产或自然流产(SA)之间均无显著关联(RR分别为1.008,95%CI = 0.909 - 1.118和RR = 1.062,95%CI = 0.902 - 1.250)。未生育女性流产1次和>2次均未增加患乳腺癌的风险。敏感性分析表明,我们的结果可靠且稳定。

结论

基于流行病学研究的现有证据表明,未生育女性的流产与乳腺癌风险之间无关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e946/7220471/da64457c76c3/medi-99-e20251-g001.jpg

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