Reproductive history and breast cancer survival: Findings from the African breast cancer-Disparities in outcomes cohort and implications of Africa's fertility transition on breast cancer prognosis.
Reproductive history and breast cancer survival: Findings from the African breast cancer-Disparities in outcomes cohort and implications of Africa's fertility transition on breast cancer prognosis.
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DOI：
10.1002/ijc.34411
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发表时间：
2023-05-01
影响因子：
6.4
通讯作者：
中科院分区：
文献类型：
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作者：
生殖特征是乳腺癌的已知危险因素，但除了近期出生外，其作为预后因素的作用尚不清楚，并且尚未在撒哈拉以南非洲 (SSA) 进行研究。在这种情况下，我们在非洲乳腺癌——结果差异队列研究的一个子集中检查了生殖因素是否独立影响乳腺癌的生存。在 2014 年至 2017 年间招募的 1485 名乳腺癌女性中，我们检查了出生队列中生殖因素的变化，并使用 Cox 模型来检查在调整混杂因素（年龄、分期、治疗、艾滋病毒和社会因素）后，生殖特征是否与全因死亡率相关。诊断四年后，822 名 (56%) 女性死亡。中位产次为 4 (IQR=2, 6)，209 名 (28%) 绝经前妇女最近生育过孩子（癌症诊断前不到三年）。每次怀孕都会导致死亡率增加 5% (95% CI: 2%, 8%)，绝经后妇女死亡率增加 5% (5%, (1%-9%))。最近生育的绝经前妇女的死亡率要高出 52%（20%、92%）。按出生队列划分的生育率趋势显示，胎次下降、首次生育年龄增加和末次生育年龄下降，但预计这些人口水平变化对未来平均生存率的影响非常小（绝对增益<3%）。
Reproductive characteristics are known risk factors for breast cancer but, other than recent birth, their role as prognostic factors is less clear, and has not been studied in Sub-Saharan Africa (SSA). In this setting, we examined whether reproductive factors independently influence breast cancer survival in a subset of the African Breast Cancer – Disparities in Outcomes cohort study. In 1485 women with incident breast cancer recruited between 2014 and 2017, we examined birth cohort changes in reproductive factors, and used Cox models to examine whether reproductive characteristics were associated with all-cause mortality after adjusting for confounders (age, stage, treatment, HIV, and social factors). Four years after diagnosis, 822 (56%) women had died. Median parity was 4 (IQR=2, 6) and 209 (28%) of premenopausal women had had a recent birth (less than three years prior to cancer diagnosis). Each pregnancy was associated with a 5% increase (95% CI: 2%, 8%) in mortality rates, which held among postmenopausal women (5%, (1%-9%)). Pre-menopausal women with a recent birth had 52% (20%, 92%) higher mortality rates. Fertility trends by birth cohort showed declining parity, increasing age at first birth and declining age at last birth, however the impact of these population-level changes on future average survival was predicted to be very small (<3% absolute gain).
影响因子：
8.8
作者：
Perks, CC;Keith, AJ;Goodhew, KL;Savage, PB;Winters, ZE;Holly, JMP
通讯作者：
Holly, JMP
影响因子：
3.7
作者：
Song N;Choi JY;Sung H;Jeon S;Chung S;Song M;Park SK;Han W;Lee JW;Kim MK;Yoo KY;Ahn SH;Noh DY;Kang D
通讯作者：
Kang D
DOI：
10.1186/1472-6874-14-113
发表时间：
2014-09-18
期刊：
BMC women's health
影响因子：
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作者：
Lee J;Oh M;Korean Breast Cancer Society
通讯作者：
Korean Breast Cancer Society