BLADDER-CANCER, PARITY, AND AGE AT 1ST BIRTH
BLADDER-CANCER, PARITY, AND AGE AT 1ST BIRTH
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DOI：
10.1007/bf00051913
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发表时间：
1992-01-01
影响因子：
2.3
通讯作者：
JOHNSON, D
中科院分区：
文献类型：
--
作者：
CANTOR, KP;LYNCH, CF;JOHNSON, D
男性膀胱癌发病率高（美国男性：女性比例为4：1）不能完全用吸烟习惯或职业暴露的性别差异来解释。实验室研究表明，一些雄激素刺激（或不抑制）膀胱组织中的肿瘤发生，而雌激素则具有相反的作用。这些观察结果表明，女性膀胱癌的风险可能会受到性激素的影响，这些激素在怀孕期间和怀孕后会发生深刻的变化。来自爱荷华州的317例女性病例和833例以人群为基础的对照的邮寄问卷数据被用来测量产次和母亲初次生育年龄对膀胱癌风险的影响。经调整年龄、吸烟和既往膀胱感染后，经产妇女相对于未经产妇女的风险降低（比值比[OR] = 0.67，95%置信区间[CI] = 0.44-1.00）。总体风险降低仅限于从不吸烟的女性（OR = 0.51，CI = 0.30-0.88），在曾经吸烟者中没有明显的均等效应（OR = 0.93，CI = 0.49-1.77）。风险似乎随着第一胎年龄的增加而降低，但在第一胎后随着产次的增加而变化。我们的研究结果是一致的假设，即人类膀胱移行细胞组织中的肿瘤发生受到性激素的影响，从而与怀孕有关的激素变化可以降低风险。
The excess of bladder cancer in males (M:F ratio of 4:1 in the United States) is not explained fully by gender differences in smoking habits or occupational exposures. Laboratory studies suggest that some androgenic hormones stimulate (or do not inhibit) oncogenesis in bladder tissue, and that estrogenic hormones have the opposite effect. These observations suggest that bladder cancer risk in females may be modified by sex hormones which undergo profound changes during and following pregnancy. Mail-questionnaire data from 317 incident female cases, and 833 population-based controls in Iowa were used to measure the effect of parity and maternal age at first birth on bladder cancer risk. Parous women were at decreased risk relative to nulliparous women (odds ratio [OR] = 0.67, 95 percent confidence interval [CI] = 0.44-1.00), after adjustment for age, tobacco use, and previous bladder infection. The overall risk reduction was restricted to women who had never smoked (OR = 0.51, CI = 0.30-0.88), with no apparent effect of parity among ever-smokers (OR = 0.93, CI = 0.49-1.77). Risk appeared to decrease with increasing age at first birth, but did not vary with increasing parity after the first birth. Our findings are consistent with the hypothesis that oncogenesis in transitional cell tissue of the human bladder is influenced by sex hormones, and that hormonal changes related to pregnancy thereby can decrease risk.