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首次足月妊娠年龄、哺乳情况、产次与乳腺癌风险:西班牙的一项病例对照研究

Age at first full-term pregnancy, lactation and parity and risk of breast cancer: a case-control study in Spain.

作者信息

Ramon J M, Escriba J M, Casas I, Benet J, Iglesias C, Gavalda L, Torras G, Oromi J

机构信息

Preventive Medicine Department, Ciutat Sanitaria i Universitaria de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.

出版信息

Eur J Epidemiol. 1996 Oct;12(5):449-53. doi: 10.1007/BF00143995.

Abstract

A case-control study was carried out in Spain to assess associations between parity, lactation and age at first full-term pregnancy and breast cancer. From November 1989 to February 1992, 184 incident breast cancer histologically confirmed cases were interviewed and matched by age and residence to 184 hospitalized patients and 184 community controls selected by random digit dialing. Multiple logistic regression was used to assess the independent influence of each factor on the risk of breast cancer in relation to other factors included in the model. Age at first full-term pregnancy was associated with breast cancer risk with an estimated odds ratio of 3.5 (95% CI 1.41-9.83) for women with their first birth after 30 years in comparison with those whose first birth was before age 21. Breast cancer risk decreased with increasing number of full-term pregnancies, OR 0.3 (95% CI 0.16-0.78) for women who had had more than 3 full-term pregnancies in comparison with nulliparous women. Among parous women, the estimated OR for women with more than 3 children was 0.4 (95% CI 0.13-0.81) after allowance for age at first childbirth and lactation. The estimated OR was 2.6 (95% CI 1.4-4.7) for women with a positive history of breast cancer in first-degree relatives. Breast cancer was not associated with total duration of lactation. The study indicates that parity is an independent risk factor associated to breast cancer and that the women with a late age at first full-term pregnancy constitute a high-risk group.

摘要

在西班牙开展了一项病例对照研究,以评估产次、哺乳情况以及首次足月妊娠年龄与乳腺癌之间的关联。1989年11月至1992年2月,对184例经组织学确诊的乳腺癌新发病例进行了访谈,并按照年龄和居住地与184名住院患者以及通过随机数字拨号选定的184名社区对照进行匹配。采用多因素logistic回归分析来评估每个因素相对于模型中纳入的其他因素对乳腺癌风险的独立影响。首次足月妊娠年龄与乳腺癌风险相关,与首次生育年龄在21岁之前的女性相比,30岁之后首次生育的女性估计比值比为3.5(95%可信区间1.41 - 9.83)。乳腺癌风险随着足月妊娠次数的增加而降低,与未生育女性相比,足月妊娠超过3次的女性比值比为0.3(95%可信区间0.16 - 0.78)。在经产妇中,在考虑首次分娩年龄和哺乳情况后,子女数超过3个的女性估计比值比为0.4(95%可信区间0.13 - 0.81)。一级亲属有乳腺癌阳性家族史的女性估计比值比为2.6(95%可信区间1.4 - 4.7)。乳腺癌与哺乳总时长无关。该研究表明,产次是与乳腺癌相关的一个独立危险因素,首次足月妊娠年龄较晚的女性构成一个高危群体。

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