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成年早期超重和肥胖与绝经前卵巢癌和包括受体状态在内的绝经前乳腺癌的风险:近 50 万丹麦女性的前瞻性队列研究。

Early adulthood overweight and obesity and risk of premenopausal ovarian cancer, and premenopausal breast cancer including receptor status: prospective cohort study of nearly 500,000 Danish women.

机构信息

Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.

Unit of Statistics and Data analysis, Danish Cancer Society Research Center, Copenhagen, Denmark.

出版信息

Ann Epidemiol. 2022 Jun;70:61-67. doi: 10.1016/j.annepidem.2022.03.013. Epub 2022 Apr 8.

Abstract

PURPOSE

To assess the association between higher-than-normal BMI and incidence of premenopausal ovarian and breast cancers.

METHODS

This prospective cohort study included 461,646 women registered in the Danish Medical Birth Registry with self-reported early adulthood BMI ≥18.5 kg/m, without a history of cancer. We used Cox proportional hazards regression models to estimate the hazard ratios (HRs) with 95% confidence intervals (95% CIs) of premenopausal epithelial ovarian cancer, breast cancer, estrogen receptor positive and negative, HER2 positive and negative breast cancers according to BMI.

RESULTS

Compared with normal weight, obesity was associated with higher rates of premenopausal ovarian cancer (HR = 1.95, 95% CI 1.19-3.21) when adjusted for parity, use of hormonal contraception, family history of ovarian and/or breast cancer, other cancer, and calendar year. Obesity was associated with lower rates of premenopausal breast cancer (HR = 0.77, 95% CI 0.68-0.87) when adjusted for parity, use of hormonal contraception, family history of ovarian and/or breast cancer, any other cancer, calendar year, smoking, and highest achieved education. The associations were strongest with estrogen receptor positive premenopausal breast cancers. Results according to HER2 status were similar to overall results for premenopausal breast cancer.

CONCLUSIONS

Obesity was associated with higher incidence of premenopausal ovarian cancer and lower incidence of premenopausal breast cancer.

摘要

目的

评估高于正常 BMI 与绝经前卵巢癌和乳腺癌发病风险的相关性。

方法

本前瞻性队列研究纳入了 461646 名在丹麦医学出生登记处注册的、自我报告的早期成年 BMI≥18.5kg/m²且无癌症病史的女性。我们使用 Cox 比例风险回归模型,根据 BMI 估计了绝经前上皮性卵巢癌、乳腺癌、雌激素受体阳性和阴性、HER2 阳性和阴性乳腺癌的风险比(HR)及其 95%置信区间(95%CI)。

结果

与正常体重相比,调整了产次、激素避孕使用情况、卵巢和/或乳腺癌家族史、其他癌症以及日历年后,肥胖与绝经前卵巢癌的发生率较高相关(HR=1.95,95%CI 1.19-3.21)。调整了产次、激素避孕使用情况、卵巢和/或乳腺癌家族史、任何其他癌症、日历年、吸烟和最高受教育程度后,肥胖与绝经前乳腺癌的发生率较低相关(HR=0.77,95%CI 0.68-0.87)。与雌激素受体阳性的绝经前乳腺癌相关性最强。HER2 状态的结果与绝经前乳腺癌的总体结果相似。

结论

肥胖与绝经前卵巢癌的发病率较高和绝经前乳腺癌的发病率较低相关。

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