Invited commentary: reproductive organ surgeries and breast cancer risk--apples, oranges, or fruit cocktail?

Invited commentary: reproductive organ surgeries and breast cancer risk--apples, oranges, or fruit cocktail?
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特邀评论:生殖器官手术和乳腺癌风险——苹果、橙子还是水果鸡尾酒?

DOI:
10.1093/aje/kws438
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发表时间:
2013
影响因子:
5
通讯作者:
Bernstein,Leslie
Bernstein,Leslie
中科院分区:
医学2区
文献类型:
--
作者:
Press,DavidJ;Bernstein,Leslie

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病例对照和队列研究几乎总是由于非随机暴露分配而变得复杂,在设计和分析阶段必须将其最小化。输卵管绝育术是一种常见的妇科手术,可能与其他生殖器官手术有关,这反过来又可能与乳腺癌风险有关。在本期杂志中,Gaudet等人(Am J Epidemiol.2013;177(6):492-499)成功地论证了输卵管绝育与乳腺癌风险无关。对纳入荟萃分析的异质性研究的审查强调了混杂和效应修正在观察性流行病学研究中的作用。具体来说,输卵管绝育与乳腺癌风险无关,但卵巢切除术或子宫切除术,或两者兼而有之,这些程序的时间需要在设计,分析和解释生殖因素的观察性研究中仔细考虑。
Case-control and cohort studies are almost always complicated by nonrandom exposure allocation, which must be minimized in the design and analysis phases. Tubal sterilization is a common gynecological procedure that may be associated with other reproductive organ surgeries, which in turn may be associated with breast cancer risk. In this issue of theJournal, Gaudet et al. (Am J Epidemiol.2013;177(6):492–499) argue successfully that tubal sterilization is unassociated with breast cancer risk. Scrutiny of the heterogeneous studies included in their meta-analysis underscores the role of confounding and effect modification in observational epidemiologic studies. Specifically, tubal sterilization is unassociated with breast cancer risk, but either oophorectomy or hysterectomy, or both, and the timing of these procedures warrant careful consideration in the design, analysis, and interpretation of observational research on reproductive factors.
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