Purdie D, Green A, Bain C, Siskind V, Ward B, Hacker N, Quinn M, Wright G, Russell P, Susil B
Queensland Institute of Medical Research, Brisbane, Australia.
Int J Cancer. 1995 Sep 15;62(6):678-84. doi: 10.1002/ijc.2910620606.
Of the few factors known to be associated with epithelial ovarian cancer, the most consistently observed relate to women's reproductive function, although even here uncertainties remain. We have undertaken a case-control study involving personal interviews with over 1,600 women, the largest of its kind to date, to investigate further the associations between women's reproductive histories and other factors and the development of ovarian cancer. Cases were drawn from women diagnosed with epithelial ovarian cancer in 3 Australian states, Queensland, New South Wales and Victoria, between August 1990 and December 1993, and controls were drawn at random from the electoral roll, stratified by age and geographic region. Trained interviewers administered standard questionnaires to obtain detailed information about women's reproductive and contraceptive histories and other factors of interest, such as smoking and family history of ovarian or other cancer. Findings were based on data from 824 cases and 860 controls and confirmed the reduced risk of ovarian cancer associated with increasing parity and duration of use of the oral contraceptive pill (OCP), hysterectomy and tubal ligation. The strongest association of all was seen with use of the OCP for 10 years or more. An inverse association between ovarian cancer and age at first birth was observed, but this was not statistically significant. There were no associations between development of ovarian cancer and number of incomplete pregnancies, use of hormone replacement therapy or menstrual history. Among other factors considered, education after leaving school was negatively associated and high body mass index, family history of ovarian cancer, use of talc in the abdominal or perineal region and smoking were positively associated with occurrence of ovarian cancer.
在已知的与上皮性卵巢癌相关的少数因素中，最常观察到的与女性生殖功能有关，尽管即便在此方面仍存在不确定性。我们开展了一项病例对照研究，对1600多名女性进行了个人访谈，这是迄今为止此类研究中规模最大的一次，旨在进一步调查女性生殖史及其他因素与卵巢癌发病之间的关联。病例取自1990年8月至1993年12月期间在澳大利亚三个州（昆士兰州、新南威尔士州和维多利亚州）被诊断为上皮性卵巢癌的女性，对照则从选民名单中随机抽取，并按年龄和地理区域进行分层。训练有素的访谈员发放标准问卷，以获取有关女性生殖和避孕史以及其他相关因素（如吸烟和卵巢癌或其他癌症家族史）的详细信息。研究结果基于824例病例和860名对照的数据，证实了随着产次增加、口服避孕药（OCP）使用时间延长、子宫切除术和输卵管结扎，卵巢癌风险降低。所有关联中最强的是使用OCP达10年或更长时间。观察到卵巢癌与初产年龄之间存在负相关，但这在统计学上并不显著。卵巢癌发病与不完全妊娠次数、激素替代疗法的使用或月经史之间无关联。在考虑的其他因素中，离校后教育呈负相关，而高体重指数、卵巢癌家族史、腹部或会阴区域使用滑石粉以及吸烟与卵巢癌发生呈正相关。
