Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia.
Department of Medicine, Weill Cornell Medicine, New York, New York.
Cancer Epidemiol Biomarkers Prev. 2022 Jan;31(1):28-37. doi: 10.1158/1055-9965.EPI-21-0438. Epub 2021 Oct 20.
We undertook a systematic review and appraised the evidence for an effect of circulating sex steroid hormones and sex hormone-binding globulin (SHBG) on breast cancer risk in pre- and postmenopausal women. Systematic searches identified prospective studies relevant to this review. Meta-analyses estimated breast cancer risk for women with the highest compared with the lowest level of sex hormones, and the DRMETA Stata package was used to graphically represent the shape of these associations. The ROBINS-E tool assessed risk of bias, and the GRADE system appraised the strength of evidence. In premenopausal women, there was little evidence that estrogens, progesterone, or SHBG were associated with breast cancer risk, whereas androgens showed a positive association. In postmenopausal women, higher estrogens and androgens were associated with an increase in breast cancer risk, whereas higher SHBG was inversely associated with risk. The strength of the evidence quality ranged from low to high for each hormone. Dose-response relationships between sex steroid hormone concentrations and breast cancer risk were most notable for postmenopausal women. These data support the plausibility of a role for sex steroid hormones in mediating the causal relationship between physical activity and the risk of breast cancer..
我们进行了系统的回顾，并评估了循环性激素和性激素结合球蛋白（SHBG）对绝经前和绝经后妇女乳腺癌风险的影响的证据。系统搜索确定了与本综述相关的前瞻性研究。荟萃分析估计了具有最高和最低性激素水平的女性的乳腺癌风险，并且使用 DRMETA Stata 包以图形方式表示这些关联的形状。ROBINS-E 工具评估了偏倚风险，GRADE 系统评估了证据的强度。在绝经前妇女中，雌激素、孕激素或 SHBG 与乳腺癌风险之间几乎没有关联，而雄激素则显示出正相关。在绝经后妇女中，较高的雌激素和雄激素与乳腺癌风险增加有关，而较高的 SHBG 与风险呈负相关。每种激素的证据质量强度从低到高不等。绝经后妇女的性激素浓度与乳腺癌风险之间的剂量-反应关系最为明显。这些数据支持性激素在介导体力活动与乳腺癌风险之间的因果关系方面的作用的合理性。
