Hsieh C, Pavia M, Lambe M, Lan S J, Colditz G A, Ekbom A, Adami H O, Trichopoulos D, Willett W C
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115.
Eur J Cancer. 1994;30A(7):969-73. doi: 10.1016/0959-8049(94)90125-2.
This study examined whether breast cancer risk increased for a short period after childbirth, but decreased after a longer period of time. Data from an international case-control study on breast cancer conducted in the 1960s were used to study the modifying effect of age at enrolment on the relationship between parity and breast cancer risk, comparing first uniparous with nulliparous women, and then biparous versus uniparous women. The statistical analysis was performed by modelling through multiple logistic regression, adjusting for study site, age at menarche, menopausal status and obesity index. Comparing uniparous with nulliparous women, an early age at birth seems to be protective for all periods after birth, whereas a late age at birth imparts a higher risk than nulliparity in the period immediately after birth, which declines with the passage of time. The modification effect by age was not apparent when biparous women with different age at second birth were compared with uniparous women. The results support the hypothesis that pregnancy oestrogens impart a transient increase of maternal breast cancer risk when the full-term pregnancy occurs late in a woman's life.
本研究调查了产后短期内乳腺癌风险是否增加,但长期后是否降低。利用20世纪60年代进行的一项国际乳腺癌病例对照研究的数据,研究入组年龄对生育次数与乳腺癌风险关系的修正作用,比较初产妇与未产妇,然后是经产妇与初产妇。通过多元逻辑回归建模进行统计分析,对研究地点、初潮年龄、绝经状态和肥胖指数进行校正。比较初产妇与未产妇,出生时年龄较小似乎对出生后的所有时期都有保护作用,而出生时年龄较大在出生后立即比未生育有更高的风险,这种风险会随着时间的推移而下降。当比较不同二胎年龄的经产妇与初产妇时,年龄的修正作用并不明显。结果支持这样的假设,即当足月妊娠发生在女性生命后期时,孕期雌激素会使母亲患乳腺癌的风险短暂增加。