Cancer risk after a hospital discharge diagnosis of endometriosis
Cancer risk after a hospital discharge diagnosis of endometriosis
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DOI：
10.1016/s0002-9378(97)70550-7
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发表时间：
1997-03-01
影响因子：
9.8
通讯作者：
Bergqvist, A
中科院分区：
文献类型：
--
作者：
Brinton, LA;Gridley, G;Bergqvist, A
目的：我们的目标是确定癌症的风险后，住院治疗子宫内膜异位症。研究设计：记录20,686名妇女子宫内膜异位症住院期间，1969年至1983年，确定通过全国范围内的瑞典住院病人登记，与瑞典国家癌症登记处通过1989年，以确定所有后续诊断的癌症。研究受试者平均随访11.4年，队列随访216，851女性年。标准化的发病率是通过使用来自瑞典人群的年龄和时期特异性发病率计算的。由于高比例的受试者与妇科手术（55.6%），妇科癌症的风险评估涉及截断人年在任何这样的operation.RESULTS：整体癌症的风险为1.2（95%置信区间1.1至1.3）。乳腺癌（标准化发病率= 1.3，95%置信区间1.1 - 1.4）、卵巢癌（1.9，1.3 - 2.8）和造血系统恶性肿瘤（1.4，1.0 - 1.8）显著过量;后者过量主要是由非霍奇金淋巴瘤（1.8，1.2 - 2.6）的过量风险驱动的。在有长期卵巢子宫内膜异位症病史的受试者中，卵巢癌的风险尤其高（4.2，2.0 - 7.7）。子宫颈癌的风险略有下降（0.7，0.4至1.3），而没有相关性，观察到子宫内膜癌（1.1，0.6至1.9）。结论：这些研究结果表明，应进一步关注的风险，乳腺癌，卵巢癌和造血系统癌症的妇女子宫内膜异位症，并探讨可能的激素和免疫的原因，过度的风险。
OBJECTIVES: Our goal was to determine the risk of cancer after hospitalization for endometriosis.STUDY DESIGN: Records of 20,686 women hospitalized with endometriosis during the period 1969 to 1983, as identified through the nationwide Swedish Inpatient Register, were linked against the National Swedish Cancer Registry through 1989 to identify all subsequent diagnoses of cancer. The study subjects were followed up for a mean of 11.4 years, with the cohort contributing 216,851 woman years of follow-up. Standardized incidence ratios were computed by the use of age- and period-specific incidence rates derived from the Swedish population. Because of the high proportion of subjects with gynecologic operations (55.6%), evaluation of the risk of gynecologic cancers involved truncation of person years at the time of any such operation.RESULTS: The overall cancer risk was 1.2 (95% confidence interval 1.1 to 1.3). Significant excesses were observed for breast cancer (standardized incidence ratio = 1.3, 95% confidence interval 1.1 to 1.4), ovarian cancer (1.9, 1.3 to 2.8), and hematopoietic malignancies (1.4, 1.0 to 1.8); this latter excess was largely driven by an excess risk of non-Hodgkin's lymphoma (1.8, 1.2 to 2.6). The risk of ovarian cancer was particularly elevated among subjects with a long-standing history of ovarian endometriosis (4.2, 2.0 to 7.7). Cervical cancer risk was slightly reduced (0.7, 0.4 to 1.3) whereas no association was observed for cancer of the endometrium (1.1, 0.6 to 1.9).CONCLUSIONS: These findings suggest that further attention be given to the risk of breast, ovarian and hematopoietic cancers among women with endometriosis and to exploring possible hormonal and immunologic reasons for the excess risks.