Paffenbarger R S, Kampert J B, Chang H G
Am J Epidemiol. 1980 Aug;112(2):258-68. doi: 10.1093/oxfordjournals.aje.a112992.
In a case-control study of 1868 breast cancer patients and 3391 control patients we searched for characteristics that predicted risk of breast cancer diagnosed before and after menopause. Common to increased risk of this disease in both periods of womanhood were: early menarche and late menopause; delayed marriage and first childbirth; more nulliparity or reduced gravidity and parity; reduced frequency of abortions; shorter overall child-bearing interval; more advanced education, higher socioeconomic status, and more contraceptive usage; and familial tendencies toward the disease. Breast cancer patients diagnosed before menopause were leaner than controls at age 20 and at time of diagnosis, but breast cancer risk in the postmenopausal period was related to increased weight-for-height at diagnosis and greater weight-for-height at diagnosis and greater weight gain since age 20. Postmenopausal breast cancer patients had a longer interval between first and second childbirths. Frequency and duration of the gravid state, inversely related to breast cancer risk, were largely dependent on contraceptive practices rather than unexplained infertility per se. Whether the breast cancer reaches diagnosis before or after menopause, the bulk of evidence examined here supports the view that it has a common cause and is subject to modifying influences over the long period of cancer latency.
在一项针对1868例乳腺癌患者和3391例对照患者的病例对照研究中，我们探寻了可预测绝经前后乳腺癌发病风险的特征。在女性的这两个时期，该疾病风险增加的共同因素有：初潮早和绝经晚；结婚和首次生育延迟；未育或妊娠及生育次数减少；流产频率降低；总的生育间隔较短；受教育程度更高、社会经济地位更高以及更多地使用避孕药具；以及家族患病倾向。绝经前被诊断出乳腺癌的患者在20岁及诊断时比对照组更瘦，但绝经后乳腺癌风险与诊断时身高体重增加以及自20岁起身高体重增加幅度更大有关。绝经后乳腺癌患者的第一胎和第二胎生育间隔更长。妊娠状态的频率和持续时间与乳腺癌风险呈负相关，这在很大程度上取决于避孕措施，而非无法解释的不孕本身。无论乳腺癌在绝经前还是绝经后被诊断出，此处所研究的大量证据都支持这样一种观点，即它有一个共同病因，并且在癌症潜伏期的很长一段时间内会受到多种影响因素的作用。
