Childbearing at older age and endometrial cancer risk (Sweden)
Childbearing at older age and endometrial cancer risk (Sweden)
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DOI：
10.1023/a:1008860615584
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发表时间：
1999-02-01
影响因子：
2.3
通讯作者：
Hsieh, CC
中科院分区：
文献类型：
--
作者：
Lambe, M;Wuu, J;Hsieh, CC
目的：一些研究发现，最后一次生育的年龄与子宫内膜癌风险之间存在负相关。巢式病例对照研究进行了审查的影响，这方面和其他方面的生殖模式的风险发展endometrial cancer.Methods：在1925年及以后出生的妇女中，4,839名符合条件的患者被确定在瑞典癌症登记。对于每种情况，从基于人口的生育登记册中随机选择五个单独年龄匹配的对照。结果：与单胎妇女相比，无子女妇女患子宫内膜癌的风险更高（OR = 1.38，95%可信区间CI = 1.25-1.52）。这种关联在年轻（< 50岁）女性中比在老年（50岁以上）女性中更强。在所有年龄段的第一胎，分娩与子宫内膜癌的风险降低有关，随着时间的推移，子宫内膜癌的风险逐渐降低。在经产妇女中，每增加一个活产，风险降低近20%（OR = 0.81，CI = 0.78-0.84）。在一项仅限于两次或两次以上生育的妇女的分析中，比较了第一次和最后一次生育年龄的独立影响，只有最后一次生育年龄较大与子宫内膜癌风险降低相关。风险下降的速度约为15%，每五年延迟的最后birth.Conclusions：子宫内膜癌通常被称为原型的子宫内膜癌决定的疾病的妇女。然而，我们的研究结果进一步支持了这一假设，即出生不仅可能通过激素影响来影响风险，还可能通过经历恶性转化的细胞的机械脱落来影响风险。
Objectives: Several studies have found an inverse association between older age at last birth and endometrial cancer risk. A nested case-control study was undertaken to examine the influence of this and other aspects of reproductive patterns on the risk of developing endometrial cancer.Methods: Among women born in 1925 and later, 4,839 eligible patients were identified in the Swedish Cancer Register. For each case, five individually age-matched controls were randomly selected from a population-based Fertility Register. Relative risks were estimated from odds ratios obtained from conditional logistic regression analyses.Results: Compared to uniparous women, childless women were at a higher risk of endometrial cancer (odds ratio [OR] = 1.38, 95% confidence interval [CI] = 1.25-1.52). This association was stronger in younger (< 50 years) than in older (50 + years) women. At all ages of first birth, a delivery was associated with a reduced risk of endometrial cancer that slowly diminished with time. Among parous women, the risk decreased by almost 20% for each additional live birth (OR = 0.81, CI = 0.78-0.84). In an analysis limited to women with two or more births that compared the independent effects of age at first and at last birth, only older age at last birth was associated with a lowered risk of endometrial cancer. The risk decreased at a rate of about 15% per five-year delay of last birth.Conclusions: Endometrial cancer is often referred to as the prototype hormonally-determined disease in women. However, our findings give further support to the hypothesis that a birth may not only affect risk through hormonal influences, but possibly also through mechanical shedding of cells that have undergone malignant transformation.