Talamini R, Franceschi S, Dal Maso L, Negri E, Conti E, Filiberti R, Montella M, Nanni O, La Vecchia C
Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano, Italy.
Eur J Cancer. 1998 Jun;34(7):1070-6. doi: 10.1016/s0959-8049(98)00019-7.
A case-control study was conducted between 1992 and 1996 in six Italian areas. It included 537 women with colon cancer, 291 women with rectal cancer and 2081 control women in hospital for acute conditions, unrelated to hormonal or gynaecological diseases. A higher age at menopause was associated with increased colon cancer risk (odds ratio (OR) for > or = 53 years compared with < 50 years = 1.39, 95% confidence interval (CI) 1.04-1.87). Among parous women, a significant trend of decreasing colon cancer risk with increasing number of births was seen for colon (OR for > or = 4 births compared with 1 birth = 0.62, 95% CI 0.42-0.90), but not for rectal cancer. Nulliparous women, however, were at lower risk than women with a single birth, and age at first birth was directly associated with risk. While oral contraceptive use showed no significant influence, ever users of hormone replacement therapy had a reduced risk of rectal cancer (OR = 0.56, 95% CI 0.31-1.01). Thus, the association of colorectal cancer with reproductive and menstrual factors is neither strong nor consistent.
1992年至1996年期间，在意大利的六个地区开展了一项病例对照研究。该研究纳入了537名结肠癌女性患者、291名直肠癌女性患者以及2081名因急性疾病住院的对照女性，这些急性疾病与激素或妇科疾病无关。绝经年龄较大与结肠癌风险增加相关（≥53岁与＜50岁相比的优势比（OR）=1.39，95%置信区间（CI）为1.04 - 1.87）。在经产妇中，结肠癌风险随生育次数增加而降低的趋势显著（≥4次生育与1次生育相比的OR = 0.62，95% CI为0.42 - 0.90），但直肠癌并非如此。然而，未生育女性的风险低于单胎生育女性，且初产年龄与风险直接相关。虽然口服避孕药的使用未显示出显著影响，但曾使用激素替代疗法的女性患直肠癌的风险降低（OR = 0.56，95% CI为0.31 - 1.01）。因此，结直肠癌与生殖和月经因素之间的关联既不强烈也不一致。
