den Tonkelaar I, de Waard F
Department of Epidemiology, University of Utrecht, The Netherlands.
Breast Cancer Res Treat. 1996;38(3):253-8. doi: 10.1007/BF01806143.
The effect of regularity and length of the menstrual cycle on breast cancer risk was studied prospectively in 78 cases and 383 age-matched controls who participated in a breast cancer screening programme, the DOM-project, in Utrecht, the Netherlands. Before entering the screening programme when they were aged 41-46, the women kept a menstrual calendar during at least three consecutive cycles. Cycles were considered to be irregular if any of three cycles was shorter than 21 days or longer than 35 days and/or if variation between cycle lengths was more than five days. Women with irregular cycles had a significantly reduced risk of breast cancer (odds ratio = 0.44; 95% confidence interval 0.22-0.86) after adjustment for age at menarche, age at first birth, parity, Quetelet's index and family history of breast cancer. Among regularly menstruating women, long cycles (28 days or more) were not significantly associated with increased risk of breast cancer (odds ratio 1.17; 95% confidence interval 0.66-2.09). To the extent that irregular menstrual cycles reflect anovulatory cycles, our findings support the hypothesis that the cumulative number of regular ovulatory cycles increases breast cancer risk.
在荷兰乌得勒支市开展的一项名为DOM项目的乳腺癌筛查计划中,对78例乳腺癌患者和383例年龄匹配的对照者进行了前瞻性研究,以探讨月经周期的规律性和长度对乳腺癌风险的影响。在41 - 46岁进入筛查计划之前,这些女性连续至少记录三个月经周期的日历。如果三个周期中有任何一个短于21天或长于35天,和/或周期长度之间的差异超过5天,则认为周期不规律。在对初潮年龄、首次生育年龄、产次、体重指数和乳腺癌家族史进行调整后,月经周期不规律的女性患乳腺癌的风险显著降低(优势比 = 0.44;95%置信区间0.22 - 0.86)。在月经周期规律的女性中,长周期(28天或更长)与乳腺癌风险增加无显著关联(优势比1.17;95%置信区间0.66 - 2.09)。就不规律月经周期反映无排卵周期而言,我们的研究结果支持这样的假设,即规律排卵周期的累积数量会增加乳腺癌风险。