Rockhill B, Moorman P G, Newman B
Channing Laboratory and Harvard School of Public Health, Boston 02115, MA, USA.
Cancer Causes Control. 1998 Aug;9(4):447-53. doi: 10.1023/a:1008832004211.
Later menarche, and a longer time until onset of regular cycling, are considered markers of lower lifetime exposure to circulating ovarian hormones. While later age at menarche is associated with reduced breast cancer risk, evidence for the relationship between time until onset of regular cycles and breast cancer is inconsistent. We evaluated both associations with breast cancer risk.
We used data from the Carolina Breast Cancer Study, a population-based case-control study of breast cancer among White and Black women aged 20 to 74 years, residing in central and eastern North Carolina (United States). Cases were diagnosed between May 1993 and June 1996. Unconditional logistic regression models were limited to women with complete data for the risk factors considered (n = 830 cases, 758 controls).
We observed an inverse relationship between age at menarche and breast cancer risk, but found little support for the hypothesis that a longer time until onset of regular menstrual cycling was associated with reduced risk of breast cancer (odds ratios = 1.0 [95 percent confidence interval (CI) = 0.7-1.5], and 1.2 [CI = 0.8-1.6], respectively, for 1-4 years and < 1 year until onset of regular cycling, relative to 5+ years). There was little relationship between age at menarche and time until regular cycling. We found strong evidence that delays in onset of regular cycling were associated with increased frequency of irregular cycles throughout young adulthood.
Given the inconsistent findings regarding the links between menstrual cycle characteristics and breast cancer, and recent recommendations to delay menarche and alter the patterns of cycles of young women in order to reduce breast cancer risk, this topic calls for further, innovative study.
月经初潮较晚以及距离规律月经周期开始的时间较长,被视为一生中循环卵巢激素暴露水平较低的标志。虽然月经初潮年龄较晚与乳腺癌风险降低有关,但关于距离规律月经周期开始的时间与乳腺癌之间关系的证据并不一致。我们评估了这两种情况与乳腺癌风险的关联。
我们使用了卡罗来纳乳腺癌研究的数据,这是一项基于人群的病例对照研究,研究对象为居住在美国北卡罗来纳州中部和东部、年龄在20至74岁之间的白人和黑人女性乳腺癌患者。病例在1993年5月至1996年6月期间被诊断出来。无条件逻辑回归模型仅限于具有所考虑风险因素完整数据的女性(n = 830例病例,758例对照)。
我们观察到月经初潮年龄与乳腺癌风险之间存在负相关,但对于规律月经周期开始时间较长与乳腺癌风险降低相关这一假设,几乎没有得到支持(相对于5年以上,规律月经周期开始时间为1 - 4年和<1年时的优势比分别为1.0 [95%置信区间(CI)=0.7 - 1.5]和1.2 [CI = 0.8 - 1.6])。月经初潮年龄与规律月经周期开始时间之间几乎没有关系。我们发现有力证据表明,规律月经周期开始延迟与整个青年期不规律月经周期频率增加有关。
鉴于月经周期特征与乳腺癌之间联系的研究结果不一致,以及最近为降低乳腺癌风险而建议推迟月经初潮并改变年轻女性月经周期模式,这个话题需要进一步的创新性研究。