De Stavola B L, Wang D Y, Allen D S, Giaconi J, Fentiman I S, Reed M J, Bulbrook R D, Hayward J L
Imperial Cancer Research Fund, London, UK.
Cancer Causes Control. 1993 Jul;4(4):331-40. doi: 10.1007/BF00051335.
The association with breast cancer of menstrual and reproductive events, family history of breast cancer, and body size have been studied on two cohorts of 6,706 volunteers on the island of Guernsey (United Kingdom), 168 of whom had breast cancer detected during follow-up. The median follow-up time of the non-cases was 21 years in the first study and 10 years in the second. A time-dependent Cox regression model was fitted to the data with age as the time-dependent variable in order to represent the effect of changing menopausal status. Other variables examined in the model were age at menarche, parity, age at first birth, family history of breast cancer, height, weight (both directly measured), relative weight (weight [kg]/height[m]), and Quetelet's body mass index (weight[kg]/height[m]2). Interactions between age and all other covariates also were examined. Family history was found to be the most important risk factor for women aged less than 51 years (relative risk [RR] = 3.5, 95 percent confidence interval [CI] = 2.0-6.0), and intervals between menarche and first birth longer than 14 years were found to increase significantly the risk of breast cancer in women older than 61 years (RR = 2.4, CI = 1.3-4.4). Height was the only indicator of body size which was associated significantly with risk of breast cancer, the estimated regression coefficient indicating an increase in risk of about 70 percent for women on the 90th centile of height relative to those on the 10th centile. A survey of the literature showed that the association between risk of breast cancer and height was found in those studies which used direct measurements of height but not in others which used self-reported values.
在根西岛(英国)的两组共6706名志愿者中,研究了月经和生殖事件、乳腺癌家族史与体型和乳腺癌之间的关联,其中168人在随访期间被检测出患有乳腺癌。在第一项研究中,非病例的中位随访时间为21年,第二项研究中为10年。将年龄作为时间依赖变量,对数据拟合时间依赖的Cox回归模型,以体现绝经状态变化的影响。模型中考察的其他变量包括初潮年龄、产次、首次生育年龄、乳腺癌家族史、身高、体重(均为直接测量值)、相对体重(体重[kg]/身高[m])和奎特莱身体质量指数(体重[kg]/身高[m]²)。还考察了年龄与所有其他协变量之间的相互作用。发现家族史是51岁以下女性最重要的风险因素(相对风险[RR]=3.5,95%置信区间[CI]=2.0 - 6.0),并且发现初潮与首次生育之间间隔超过14年的61岁以上女性患乳腺癌的风险显著增加(RR = 2.4,CI = 1.3 - 4.4)。身高是与乳腺癌风险显著相关的唯一体型指标,估计回归系数表明,身高处于第90百分位数的女性相对于第10百分位数的女性,风险增加约70%。对文献的一项调查表明,在那些使用身高直接测量值的研究中发现了乳腺癌风险与身高之间的关联,而在其他使用自我报告值的研究中则未发现。