Weiss N S, Hill D A
Department of Epidemiology, SC-36 University of Washington, Seattle 98195, USA.
Maturitas. 1996 Mar;23(2):235-9. doi: 10.1016/0378-5122(95)00976-0.
We reviewed the published medical literature to assess the impact of the use of estrogens, with and without progestogens, on the incidence of gynecologic cancer in postmenopausal women. Long-term use of an estrogen preparation that is not accompanied by a progestogen is associated with a large increase in the risk of endometrial cancer, an association that almost certainly is a causal one. The incidence of endometrial cancer in women who receive combined estrogen-progestogen therapy is not elevated to nearly the same degree. There are suggestions that, depending on the particular combined regimen, the incidence need not be elevated at all beyond that of a women who has never taken hormones. The occurrence of other forms of gynecologic cancer appear not to be associated with the use of unopposed estrogens, though relevant data on cervical cancer are sparse. The relation of ovarian, cervical and vulvar cancer to the prior use of combined estrogen-progestogen therapy has only begun to be evaluated.
我们查阅了已发表的医学文献，以评估使用雌激素（无论是否联合孕激素）对绝经后女性妇科癌症发病率的影响。长期使用不联合孕激素的雌激素制剂会使子宫内膜癌风险大幅增加，这种关联几乎肯定是因果关系。接受雌激素 - 孕激素联合治疗的女性中，子宫内膜癌的发病率升高程度远不及此。有迹象表明，根据具体的联合用药方案，其发病率不一定会高于从未使用过激素的女性。其他形式的妇科癌症的发生似乎与单纯使用雌激素无关，不过关于宫颈癌的相关数据较少。卵巢癌、宫颈癌和外阴癌与既往使用雌激素 - 孕激素联合治疗的关系才刚刚开始评估。
