Suh J S, Yoo K Y, Kwon O J, Yun I J, Han S H, Noh D Y, Choe K J
Department of Surgery, Seoul City Boramae Hospital, Dongjak-Ku, Korea.
J Korean Med Sci. 1996 Dec;11(6):501-8. doi: 10.3346/jkms.1996.11.6.501.
To support the ovarian hormone hypothesis in the etiology of breast cancer, a hospital-based case-control study with community controls was conducted to evaluate the relationship of intervals among menstrual and reproductive events to the risk of breast cancer in Korea. The cases were 190 breast cancer patients, who had been histologically diagnosed at Seoul National University Hospital from Jan. 1, 1993 to Jun. 30, 1994. Included were cancer-free women, who had undertaken the Gynecological examination at the same hospital (n=190). Women recruited for a survey of diabetes prevalence in Yonchon County, adjacent to Seoul City, were taken as a community control group (n=190). Information on menstrual and reproductive factors with other life-styles was collected through a direct interview by the well-trained interviewers. The adjusted odds ratios and the 95% confidence intervals were based on the unconditional logistic regression model. Likelihood ratio test for trend was applied for the ordinal variables. Early age at menarche, late age at natural menopause, late age at first full term pregnancy, and fewer number of full term pregnancies are independently associated with the high risk of breast cancer in Korea. Moreover, the interval between the age at menarche and the age at natural menopause of community controls (29.9+/-6.15 years) was significantly shortened compared to breast cancer cases (34.9+/-4.42 years). Particularly noteworthy was that intervals between the age at menarche and the age at first full term pregnancy of both control groups (9.0+/-3.72 years for hospital controls; 7.2+/-4.04 years for community controls) were significantly shortened compared to breast cancer cases (11.0+/-4.51 years). These findings support the hypothesis that the longer exposure to ovarian hormones during the reproductive years, the higher the risk of breast cancer.
为了支持乳腺癌病因中的卵巢激素假说，开展了一项以医院为基础、以社区人群为对照的病例对照研究，以评估韩国月经和生殖事件间隔与乳腺癌风险之间的关系。病例为190例乳腺癌患者，于1993年1月1日至1994年6月30日在首尔国立大学医院经组织学确诊。对照包括在同一家医院接受过妇科检查的无癌女性（n = 190）。从与首尔市相邻的龙仁郡招募的参与糖尿病患病率调查的女性作为社区对照组（n = 190）。通过训练有素的访谈员进行直接访谈，收集月经和生殖因素以及其他生活方式的信息。调整后的优势比和95%置信区间基于无条件逻辑回归模型。对有序变量应用趋势似然比检验。月经初潮年龄早、自然绝经年龄晚、首次足月妊娠年龄晚以及足月妊娠次数少与韩国乳腺癌高风险独立相关。此外，社区对照组月经初潮年龄与自然绝经年龄之间的间隔（29.9±6.15岁）与乳腺癌病例组（34.9±4.42岁）相比显著缩短。特别值得注意的是，两个对照组月经初潮年龄与首次足月妊娠年龄之间的间隔（医院对照组为9.0±3.72岁；社区对照组为7.2±4.04岁）与乳腺癌病例组（11.0±4.51岁）相比均显著缩短。这些发现支持了以下假说：生殖期暴露于卵巢激素的时间越长，患乳腺癌的风险越高。
