Hong Youjin, Sung Soseul, Lim Woojin, Moon Sungji, Ko Kwang-Pil, Lee Jung Eun, Kim Inah, Jee Sun Ha, Kweon Sun-Seog, Shin Min-Ho, Park Sangmin, Ryu Seung-Ho, Yang Sun Young, Kim Jeongseon, Yi Sang-Wook, Choi Yoon-Jung, Im Jeong-Soo, Seo Hong Gwan, Park Sue K
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Cancer Research Institute, Seoul National University, Seoul, Korea.
Cancer Res Treat. 2024 Nov 19. doi: 10.4143/crt.2024.707.
Population attributable fractions (PAFs) for hormone and reproductive factors have been estimated in several countries. IARC designated as Group 1 and Group 2A carcinogen for hormone factors in breast, ovarian, endometrial and uterine cervix cancer. This study aimed to estimate the PAFs of hormone/reproductive factor attributed to cancer incidence and deaths in Korean women and projected trends from 2015 to 2030.
The PAF was estimated with using the 2005 standardized prevalence rates and 2020 incidence and deaths with a 15-year latency. Based on the Levin's formula, prevalence rates were calculated using the Korea National Health and Nutrition Examination Survey (KNHANES) and the relative risks (RRs), which were the risk of selected female cancer associated with oral contraceptive, hormone replacement therapy and duration of breastfeeding, were estimated from the meta-analysis of studies performed in Korean women population. Studies based on the Asian and Global populations were calculated as a sensitivity analysis.
The estimation PAFs for hormone was 1.02% with 1,192 cases and reproductive was 2.67% with 3,112 cases. Moreover, 0.40% (125 deaths) and 1.09% (342 deaths) in female-related cancer deaths in order. EP combined HRT accounted the most proportion in hormone factors and breastfeeding in reproductive factors. Also, the breast cancer had the highest percent in both hormone and reproductive factors.
Through this study, 1.02% and 2.67% of female-related cancer incidence will be reduced by encouraging avoiding the use of oral contraceptives (OCs) and hormone replacement therapy (HRT) and breastfeeding for more than 6 months in reproductive factors. Additionally, among four selected female cancers in this study, breast cancer was observed to be a significant level of prevention.
多个国家已对激素和生殖因素的人群归因分数（PAF）进行了估算。国际癌症研究机构（IARC）将激素因素认定为乳腺癌、卵巢癌、子宫内膜癌和子宫颈癌的1类和2A类致癌物。本研究旨在估算韩国女性中激素/生殖因素对癌症发病率和死亡率的PAF，并预测2015年至2030年的趋势。
PAF采用2005年标准化患病率以及2020年发病率和死亡率（潜伏期为15年）进行估算。基于莱文公式，利用韩国国家健康与营养检查调查（KNHANES）计算患病率，并通过对韩国女性人群研究的荟萃分析估算相对风险（RRs），即与口服避孕药、激素替代疗法和母乳喂养持续时间相关的特定女性癌症风险。作为敏感性分析，计算了基于亚洲和全球人群的研究结果。
激素因素的估算PAF为1.02%（1192例），生殖因素的PAF为2.67%（3112例）。此外，女性相关癌症死亡中分别占0.40%（125例死亡）和1.09%（342例死亡）。在激素因素中，雌激素加激素替代疗法占比最大，在生殖因素中母乳喂养占比最大。在激素和生殖因素中，乳腺癌的占比均最高。
通过本研究，通过鼓励避免使用口服避孕药（OCs）和激素替代疗法（HRT）以及在生殖因素中进行超过6个月的母乳喂养，可使1.02%和2.67%的女性相关癌症发病率降低。此外，在本研究选定的四种女性癌症中，乳腺癌被观察到具有显著的预防水平。
