Sellers T A, Potter J D, Rich S S, Drinkard C R, Bostick R M, Kushi L H, Zheng W, Folsom A R
Division of Epidemiology, School of Public Health, University of Minnesota, MN 55454-1015.
J Natl Cancer Inst. 1994 Dec 21;86(24):1860-5. doi: 10.1093/jnci/86.24.1860.
Previous studies have suggested that cancers of the breast and prostate cluster in families and that the presence of both diseases in a family may be associated with increased risk of breast cancer.
Our purpose was to evaluate whether 1) prostate cancer aggregates in families with postmenopausal breast cancer, 2) families with cancers of the breast and prostate are the same ones as families with cancers of the breast and ovary, and 3) a family history of prostate cancer is associated with increased risk of postmenopausal breast cancer.
We analyzed data from a large prospective cohort study of Iowa women that were (at baseline) aged 55-69 years in 1986. At the third follow-up survey in 1992, self-reported data on family history of breast, ovarian, and prostate cancers in parents and siblings were provided by 30,883 women. Additional information was collected to ascertain whether the age-of-onset of breast cancer in mothers or sisters was before or after the age of 45 years. Cancer occurrence was documented using the State Health Registry of Iowa.
History of prostate cancer in their father or a brother was reported by 3384 (11.0%) of the women, and a total of 4090 women (13.2%) reported breast cancer in their mother or a sister. A positive family history of both cancers was reported by 556 women, significantly (two-sided P < .001) greater than the 457 women expected if the family histories were independent. The aggregation of breast, prostate, and ovarian cancers was reported by 22 participants, greater than the 2.7 expected (two-sided P < .0001). During 6 years of follow-up, 578 breast cancers were identified in the cohort at risk. Compared with women without a family history of either cancer, women with a family history of breast cancer had a relative risk (RR) of 1.37 (95% confidence interval [CI] = 1.06-1.79) if the affected relative had onset after the age of 45 years, and an RR of 1.71 (95% CI = 1.13-2.61) if the affected relative had onset at or before the age of 45. A family history of prostate cancer in the absence of a family history of breast cancer was associated with an RR of 1.19 (95% CI = .90-1.56). However, a family history of both breast and prostate cancers was associated with RRs of 2.06 (95% CI = 1.23-3.45) and 2.35 (95% CI = .97-5.67) for breast cancer onset in relatives of greater than 45 and less than or equal to 45 years, respectively.
These observations are concordant with recent reports that suggest a shared familial risk (inherited or environmental) for these hormone-dependent malignancies.
既往研究表明，乳腺癌和前列腺癌在家族中具有聚集性，且家族中同时存在这两种疾病可能与乳腺癌风险增加有关。
我们的目的是评估：1）前列腺癌在绝经后乳腺癌家族中是否聚集；2）患有乳腺癌和前列腺癌的家族与患有乳腺癌和卵巢癌的家族是否相同；3）前列腺癌家族史是否与绝经后乳腺癌风险增加有关。
我们分析了一项针对爱荷华州女性的大型前瞻性队列研究的数据，这些女性在1986年（基线时）年龄为55 - 69岁。在1992年的第三次随访调查中，30883名女性提供了关于父母及兄弟姐妹中乳腺癌、卵巢癌和前列腺癌家族史的自我报告数据。收集了额外信息以确定母亲或姐妹患乳腺癌的发病年龄是在45岁之前还是之后。使用爱荷华州州立健康登记处记录癌症发生情况。
3384名（11.0%）女性报告其父亲或兄弟有前列腺癌病史，共有4090名（13.2%）女性报告其母亲或姐妹有乳腺癌病史。556名女性报告了两种癌症的阳性家族史，显著高于（双侧P <.001）如果家族史独立时预期的457名女性。22名参与者报告了乳腺癌、前列腺癌和卵巢癌的聚集情况，高于预期的2.7例（双侧P <.0001）。在6年的随访期间，队列中有578例乳腺癌被确诊。与没有任何一种癌症家族史的女性相比，有乳腺癌家族史的女性，如果受影响的亲属发病年龄在45岁之后，其相对风险（RR）为1.37（95%置信区间[CI] = 1.06 - 1.79），如果受影响的亲属发病年龄在45岁及之前，RR为1.71（95% CI = 1.13 - 2.61）。在没有乳腺癌家族史的情况下，前列腺癌家族史与RR为1.19（95% CI =.90 - 1.56）相关。然而，乳腺癌和前列腺癌家族史与亲属中乳腺癌发病年龄大于45岁和小于或等于45岁时的RR分别为2.06（95% CI = 1.23 - 3.45）和2.35（95% CI =.97 - 5.67）相关。
这些观察结果与最近的报告一致，这些报告表明这些激素依赖性恶性肿瘤存在共同的家族风险（遗传或环境）。
