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乳腺癌的风险因素。

Risk factors for breast cancer.

作者信息

Helmrich S P, Shapiro S, Rosenberg L, Kaufman D W, Slone D, Bain C, Miettinen O S, Stolley P D, Rosenshein N B, Knapp R C, Leavitt T, Schottenfeld D, Engle R L, Levy M

出版信息

Am J Epidemiol. 1983 Jan;117(1):35-45. doi: 10.1093/oxfordjournals.aje.a113513.

Abstract

Since 1976, data were collected to evaluate risk factors for breast cancer in a hospital-based case-control study of 1185 women with breast cancer and 3227 controls. The risk of breast cancer increased with increasing age at first birth; this effect was not accounted for by parity. An early age at first birth appeared to reduce the risk relative to no pregnancy, whereas a late age at first birth was associated with a higher risk than not having a full-term pregnancy. High parity was associated with a reduction in the risk that was independent of that of age at first birth: for parity greater than or equal to 5, compared with parity 1-2, the relative risk estimate was 0.7 (95% confidence interval, 0.5-1.0). Late age at menarche was associated with a lower risk among premenopausal women but not among postmenopausal women. The relative risk decreased with increasing obesity among premenopausal women. Among postmenopausal women, the risk was higher among those who were obese, but there was no evidence of a trend with increasing body mass index. Risk did not vary materially according to history of abortion when gravidity was controlled. Risk was lower among postmenopausal women than among premenopausal women of the same age and increased with increasing age at menopause; bilateral oophorectomy reduced the risk more than hysterectomy alone. A positive history of benign breast disease, a positive family history of breast cancer, Jewish religion, and 12 or more years of education were each independently associated with an increased risk of breast cancer.

摘要

自1976年起,在一项基于医院的病例对照研究中收集数据,以评估1185例乳腺癌女性患者和3227例对照者的乳腺癌风险因素。乳腺癌风险随首次生育年龄的增加而升高;这种影响不受生育次数的影响。相对于未怀孕,早育似乎可降低风险,而晚育则比足月妊娠的风险更高。高生育次数与风险降低相关,且这种降低独立于首次生育年龄:生育次数大于或等于5次者与生育次数为1 - 2次者相比,相对风险估计值为0.7(95%置信区间,0.5 - 1.0)。初潮年龄晚与绝经前女性风险较低相关,但与绝经后女性无关。绝经前女性中,肥胖程度增加,相对风险降低。在绝经后女性中,肥胖者风险较高,但没有证据表明风险随体重指数增加呈趋势性变化。在控制妊娠次数后,流产史对风险没有实质性影响。同年龄的绝经后女性风险低于绝经前女性,且风险随绝经年龄增加而升高;双侧卵巢切除术比单纯子宫切除术更能降低风险。良性乳腺疾病阳性史、乳腺癌家族史阳性、犹太教以及接受12年或以上教育均各自独立与乳腺癌风险增加相关。

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