Fatal breast cancer risk in relation to use of unopposed estrogen and combined hormone therapy.

Fatal breast cancer risk in relation to use of unopposed estrogen and combined hormone therapy.
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DOI:
10.1007/s10549-014-2911-0
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发表时间:
2014-06
影响因子:
3.8
通讯作者:
Weiss, Noel S.
Weiss, Noel S.
中科院分区:
医学2区
文献类型:
--
作者:
Pocobelli, Gaia;Newcomb, Polly A.;Li, Christopher I.;Cook, Linda S.;Barlow, William E.;Weiss, Noel S.

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联合激素治疗(CHT)的使用与乳腺癌发病率增加有关,但尚不清楚这是否会导致乳腺癌死亡率增加。我们在加拿大萨斯喀彻温省进行了一项基于人群的巢式病例对照研究,该研究自1975年以来一直存在基于人群的处方药数据库。我们评估了致命性乳腺癌的风险与使用CHT和非对抗性雌激素治疗(EHT)的近期和持续时间的关系。共有1,288例病例和12,535例对照被纳入分析。无论是总体还是在近期或持续时间类别内,单独使用EHT与致命性乳腺癌风险无关(当前与从未使用的比值比(OR)=1.1; 95% CI(置信区间),0.8-1.3)。使用CHT(包括也使用EHT的女性)也与致命性乳腺癌风险无关(目前与从未使用的OR =0.9; 95%CI,0.7-1.3),除了目前长期使用的风险增加的建议。与先前的研究一致,我们没有观察到与使用EHT相关的致命性乳腺癌风险增加。迄今为止,只有少数研究评估了与使用CHT相关的致命性乳腺癌风险,并且总体结果不一致。
Use of combined hormone therapy (CHT) is associated with increased breast cancer incidence, but it is unclear whether this translates into increased breast cancer mortality. We conducted a population-based nested case-control study in Saskatchewan, Canada, where a population-based prescription drug database has existed since 1975. We evaluated fatal breast cancer risk in relation to recency and duration of use of CHT and unopposed estrogen hormone therapy (EHT). A total of 1,288 cases and 12,535 controls were included in the analyses. Exclusive use of EHT was not associated with fatal breast cancer risk, either overall or within categories of recency or duration (odds ratio (OR) for current versus never use=1.1; 95% CI (confidence interval), 0.8–1.3). Use of CHT (includes women who had also used EHT) was also not associated with fatal breast cancer risk (OR for current versus never use=0.9; 95% CI, 0.7–1.3), except for a suggestion of an increased risk with current long-term use. Consistent with prior studies, we observed no increased risk of fatal breast cancer associated with use of EHT. To date only a few studies have evaluated fatal breast cancer risk in relation to use of CHT, and collectively the results are inconsistent.
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