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非裔美国女性口服避孕药的使用与乳腺癌风险

Oral contraceptive use and breast cancer risk among African-American women.

作者信息

Palmer J R, Rosenberg L, Rao R S, Strom B L, Warshauer M E, Harlap S, Zauber A, Shapiro S

机构信息

Slone Epidemiology Unit, School of Public Health, Boston University School of Medicine, Brookline, MA, USA.

出版信息

Cancer Causes Control. 1995 Jul;6(4):321-31. doi: 10.1007/BF00051407.

Abstract

Recent epidemiologic studies, most of them in predominantly White populations, have suggested that long duration of oral contraceptive (OC) use may increase the risk of breast cancer at young ages. We assessed the relationship of OC use to the risk of breast cancer in African-American women aged 25 to 59 years, using interview data from a multipurpose hospital-based case-control study. Five hundred and twenty-four cases hospitalized for invasive breast cancer were compared with 1,021 controls with nonmalignant conditions unrelated to OC use. Relative risks (RR) and 95 percent confidence intervals (CI) were estimated relative to a reference category of use for less than 12 months; potential confounders were controlled by multiple logistic regression analysis. Among women under age 45, three or more years of OC use was associated with an increased risk of breast cancer: the RR estimate was 2.8 (CI = 1.5-5.0) for three to four years of use, and declined to 1.5 (CI = 08.3.0) for 10 or more years of use. Recency and timing of use did not explain the observed association. Among women aged 45 to 59, OC use was associated with little or no increase in risk: the RR estimate for three or more years of use was 1.3 (CI = 0.7-2.4). The findings add to the evidence from studies of White women and a recent study of Black women which have suggested an increased risk of breast cancer at young ages for moderate or long duration use of OCs.

摘要

近期的流行病学研究,其中大部分针对的是白人为主的人群,表明长期使用口服避孕药(OC)可能会增加年轻时患乳腺癌的风险。我们利用一项基于医院的多用途病例对照研究的访谈数据,评估了25至59岁非裔美国女性使用OC与患乳腺癌风险之间的关系。将524例因浸润性乳腺癌住院的病例与1021例患有与OC使用无关的非恶性疾病的对照进行比较。相对于使用时间少于12个月的参考类别,估计相对风险(RR)和95%置信区间(CI);通过多元逻辑回归分析控制潜在混杂因素。在45岁以下的女性中,使用OC三年或更长时间与患乳腺癌风险增加有关:使用三到四年的RR估计值为2.8(CI = 1.5 - 5.0),使用10年或更长时间则降至1.5(CI = 0.8 - 3.0)。近期使用情况和使用时间并不能解释所观察到的关联。在45至59岁的女性中,使用OC与风险增加很少或没有增加有关:使用三年或更长时间的RR估计值为1.3(CI = 0.7 - 2.4)。这些发现补充了来自白人女性研究和最近一项黑人女性研究的证据,这些研究表明,中度或长期使用OC会增加年轻时患乳腺癌的风险。

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