Goodman M T, Cologne J B, Moriwaki H, Vaeth M, Mabuchi K
Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan.
Prev Med. 1997 Jan-Feb;26(1):144-53. doi: 10.1006/pmed.1996.9979.
Findings from the Life Span Study (LSS) of the health effects of exposure to atomic bomb radiation have documented a strong dose-response relation between radiation exposure and breast cancer incidence.
We analyzed data from the LSS cohort to identify nonradiation risk factors for breast cancer and to determine whether these factors were independent of the effects of radiation on breast cancer occurrence.
Breast cancer incidence was ascertained among a cohort of 22,200 residents of Hiroshima and Nagasaki, Japan, who had completed a mail survey between 1979 and 1981 to study nonradiation risk factors for disease. During the subsequent follow-up period (average 8.31 years), 161 cases of primary breast cancer were identified through population-based tumor registries in the two cities.
The risk of breast cancer was inversely related to age at menarche and weakly positive in relation to age at menopause and years of menstruation. A significant negative association of full-term pregnancy against breast cancer was observed, although the number of pregnancies beyond the first was not related to the rate of breast cancer in the cohort. Women having their first full-term pregnancy before age 30 were at decreased risk of breast cancer relative to older women, but there was no trend. A nonsignificant, positive trend in risk was associated with increasing weight and body mass (kg/m2). The risk of breast cancer among women with a history of estrogen use was 1.64 (95% confidence interval 1.02-2.64) and with diabetes 2.06 (95% confidence interval 1.27-3.34). It was not possible to distinguish among additive and multiplicative models of the joint association of radiation dose and various non-radiation-related exposures (age at menarche, full-term pregnancy, female hormone preparations) identified in this analysis.
Nonradiation risk factors for breast cancer among Japanese atomic bomb survivors were consistent with those identified among other populations of women, although the prevalence of common risk factors was low. Reproductive factors and hormone use appear to act independently of radiation exposure on the risk of breast cancer among this population.
原子弹辐射对健康影响的寿命研究（LSS）结果证明，辐射暴露与乳腺癌发病率之间存在很强的剂量反应关系。
我们分析了LSS队列的数据，以确定乳腺癌的非辐射风险因素，并确定这些因素是否独立于辐射对乳腺癌发生的影响。
在日本广岛和长崎的22200名居民队列中确定乳腺癌发病率，这些居民在1979年至1981年期间完成了一项邮件调查，以研究疾病的非辐射风险因素。在随后的随访期（平均8.31年）内，通过这两个城市基于人群的肿瘤登记处确定了161例原发性乳腺癌病例。
乳腺癌风险与初潮年龄呈负相关，与绝经年龄和月经年限呈弱阳性相关。观察到足月妊娠与乳腺癌呈显著负相关，尽管首次妊娠后的妊娠次数与队列中的乳腺癌发病率无关。30岁前首次足月妊娠的女性患乳腺癌的风险相对于年龄较大的女性有所降低，但没有趋势。风险呈非显著的正趋势，与体重和体重指数（kg/m2）增加有关。有雌激素使用史的女性患乳腺癌的风险为1.64（95%置信区间1.02 - 2.64），患糖尿病的女性为2.06（95%置信区间1.27 - 3.34）。在本分析中确定的辐射剂量与各种非辐射相关暴露（初潮年龄、足月妊娠、女性激素制剂）的联合关联的相加模型和相乘模型之间无法区分。
日本原子弹幸存者中乳腺癌的非辐射风险因素与其他女性人群中确定的因素一致，尽管常见风险因素的患病率较低。生殖因素和激素使用似乎独立于辐射暴露对该人群中乳腺癌的风险产生影响。
