Petralia S A, Vena J E, Freudenheim J L, Marshall J R, Michalek A, Brasure J, Swanson M, Graham S
Department of Social and Preventive Medicine, State University of New York, Buffalo, USA.
Occup Environ Med. 1998 Jan;55(1):43-8. doi: 10.1136/oem.55.1.43.
In this case-control study, occupational histories were used to assess the relation between risk of breast cancer and employment in professional and managerial occupations while adjusting for reproductive and other risk factors.
Incident, primary, female cases of breast cancer diagnosed between 1986 and 1991, and randomly selected controls were interviewed to obtain detailed medical, reproductive, and occupational histories. Mantel-Haenszel crude odds ratios (OR) and 95% confidence intervals (95% CIs) were used to estimate risk of breast cancer related to the job of longest duration. Unconditional logistic regression was used to estimate crude and adjusted ORs and 95% CIs associated with having ever been employed and duration of employment in a professional or managerial occupation.
A non-significant threefold increase in risk was found among premenopausal women whose major job was in the occupational category of precision production, craft, and repair (95% CI 0.90 to 20.35). No increase in risk was found for premenopausal women whose major job was a managerial or professional occupation. However, an inverse relation between risk of premenopausal breast cancer and having ever held a professional or managerial job was observed (OR 0.53, 95% CI 0.34 to 0.82). This relation was strongest for women who worked one to 10 years (OR 0.47, 95% CI 0.29 to 0.77). Postmenopausal breast cancer was not related to professional and managerial employment.
In this population, employment in professional and managerial occupations is not associated with postmenopausal risk of breast cancer, but seems to be related to a reduction in risk of premenopausal breast cancer. Methodological limitations of this study including response rates are discussed.
在这项病例对照研究中,通过职业史来评估乳腺癌风险与从事专业和管理职业之间的关系,同时对生殖及其他风险因素进行校正。
对1986年至1991年间确诊的新发原发性女性乳腺癌病例以及随机选取的对照进行访谈,以获取详细的医疗、生殖和职业史。采用Mantel-Haenszel粗比值比(OR)和95%置信区间(95%CI)来估计与最长工作时长相关的乳腺癌风险。使用无条件逻辑回归来估计与曾经就业以及在专业或管理职业中的就业时长相关的粗OR和校正后的OR及95%CI。
在绝经前女性中,主要工作属于精密生产、手工艺和修理职业类别的人群,其风险有三倍的增加,但无统计学意义(95%CI为0.90至20.35)。绝经前女性中,主要工作为管理或专业职业的人群未发现风险增加。然而,观察到绝经前乳腺癌风险与曾经从事专业或管理工作之间存在负相关(OR为0.53,95%CI为0.34至0.82)。这种关系在工作1至10年的女性中最为明显(OR为0.47,95%CI为0.29至0.77)。绝经后乳腺癌与专业和管理职业就业无关。
在该人群中,从事专业和管理职业与绝经后乳腺癌风险无关,但似乎与绝经前乳腺癌风险降低有关。讨论了本研究包括应答率在内的方法学局限性。