Persson I
Acta Obstet Gynecol Scand Suppl. 1985;130:59-66. doi: 10.3109/00016348509157149.
Estrogen treatment of climacteric women has been found to be associated with a substantially increased risk of endometrial cancer and a possible slight excess risk of breast cancer. Numerous retrospective case-control studies, reported mainly in the United States, have provided evidence of a causal link between the use of estrogens and the development of endometrial cancer. The magnitude of the risk increase has been shown to be correlated with characteristics of the exposure, chiefly the duration of treatment and the presence of certain host factors in the patient, e.g. obesity and late menopause. Cases of endometrial cancer occurring after estrogen exposure were shown to have favorable tumor characteristics and excellent survival rates. The early results from a prospective cohort study have indicated that estrogen therapy, as practised in Sweden, is associated only with an excess risk of premalignant endometrial changes and that the addition of progestogens might exert a protective effect. The risk of breast cancer after estrogen therapy has been studied in both retrospective and prospective investigations. In the majority of these studies no evidence of an increased risk has been found. However, in two case-control and two follow-up studies the risk estimates were slightly but significantly raised in association with long-term and high-dose exposure.
已发现对更年期女性进行雌激素治疗与子宫内膜癌风险大幅增加以及乳腺癌可能略微增加的风险相关。大量主要在美国报道的回顾性病例对照研究提供了使用雌激素与子宫内膜癌发生之间存在因果关系的证据。风险增加的程度已被证明与暴露特征相关，主要是治疗持续时间以及患者体内某些宿主因素的存在，例如肥胖和绝经延迟。雌激素暴露后发生的子宫内膜癌病例显示出具有良好的肿瘤特征和出色的生存率。一项前瞻性队列研究的早期结果表明，瑞典实施的雌激素疗法仅与子宫内膜癌前病变风险增加相关，并且添加孕激素可能会起到保护作用。雌激素治疗后乳腺癌的风险已在回顾性和前瞻性研究中进行了探讨。在这些研究中的大多数中，未发现风险增加的证据。然而，在两项病例对照研究和两项随访研究中，与长期和高剂量暴露相关的风险估计略有但显著升高。
