Jacobson J S, Neugut A I, Garbowski G C, Ahsan H, Waye J D, Treat M R, Forde K A
Columbia College of Physicians and Surgeons, New York, NY, USA.
Cancer Causes Control. 1995 Nov;6(6):513-8. doi: 10.1007/BF00054159.
Events of reproductive life, such as parity and age at menarche, have been found in some but not all studies to be associated with risk for colorectal cancer in females. Because adenomatous polyps (adenomas) are precursors of colorectal cancer, we investigated whether reproductive variables were associated with colorectal adenomas. We conducted a case-control study among patients examined in three colonoscopy practices in New York City (NY, United States) from 1986 to 1988. Adenoma cases (n = 128) were defined as women who had an adenoma detected at the index colonoscopy with no history of inflammatory bowel disease, adenomas, or cancer. Controls (n = 283) were women with a normal index colonoscopy and no history of inflammatory bowel disease, adenomas, or cancer. The adjusted odds ratio (OR) for the association of early menarche (age less than 13 years) with adenomas was 0.6 (95 percent confidence interval = 0.4-0.9). Parity, history of spontaneous or induced abortion, infertility, type of menopause, age at menopause, use of oral contraceptives, and use of menopausal hormone replacement therapy were not associated statistically significantly with adenoma risk, although some possible trends were observed. Our findings do not implicate reproductive events, nulliparity, or overexposure to estrogens or to menstrual cycles as mechanisms of increased risk for colorectal neoplasia.
生殖生活中的一些事件，如生育情况和初潮年龄，在部分而非所有研究中被发现与女性患结直肠癌的风险相关。由于腺瘤性息肉（腺瘤）是结直肠癌的癌前病变，我们调查了生殖变量是否与结直肠腺瘤有关。我们在1986年至1988年于美国纽约市的三家结肠镜检查机构接受检查的患者中开展了一项病例对照研究。腺瘤病例（n = 128）定义为在首次结肠镜检查时发现腺瘤且无炎症性肠病、腺瘤或癌症病史的女性。对照（n = 283）为首次结肠镜检查正常且无炎症性肠病、腺瘤或癌症病史的女性。初潮早（年龄小于13岁）与腺瘤关联的校正比值比（OR）为0.6（95%置信区间 = 0.4 - 0.9）。生育情况、自然流产或人工流产史、不孕、绝经类型、绝经年龄、口服避孕药的使用以及绝经后激素替代疗法的使用，虽然观察到了一些可能的趋势，但在统计学上与腺瘤风险均无显著关联。我们的研究结果并未表明生殖事件、未生育或雌激素或月经周期过度暴露是结直肠肿瘤发生风险增加的机制。
