Exogenous hormones and colorectal cancer risk in Canada: associations stratified by clinically defined familial risk of cancer
Exogenous hormones and colorectal cancer risk in Canada: associations stratified by clinically defined familial risk of cancer
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DOI：
10.1007/s10552-007-9015-7
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发表时间：
2007-09-01
影响因子：
2.3
通讯作者：
McLaughlin, John R.
中科院分区：
文献类型：
--
作者：
Campbell, Peter T.;Newcomb, Polly;McLaughlin, John R.
目的本研究评估结直肠癌风险和绝经后/避孕激素之间的关联;亚组分析包括临床定义的癌症家族史的妇女。方法在加拿大安大略和纽芬兰及拉布拉多的20-74岁妇女中进行基于人群的病例对照研究。从1997年1月至2006年4月期间，从省级癌症登记处选择事件病例（n = 1，404），并通过财产记录和其他手段确定对照组（n = 1，203）。通过自填问卷收集癌症家族史、外源性药物使用和其他危险因素。多因素非条件Logistic回归分析用于估计比值比（OR）和相应的95%置信区间（CI）。（OR：0.77; CI：0.65-0.91），仅雌激素绝经后激素（OR：0.60; CI：0.47-0.75），雌激素-孕激素绝经后激素（OR：0.70; CI：0.52-0.95）。有和没有强烈的癌症家族史的妇女之间的风险估计是相似的。开始使用激素避孕药的年龄与结直肠癌风险相关;在年轻时开始使用的女性（年龄< 22岁：OR：0.60; CI：0.47-0.77）与年龄较晚开始使用的女性相比，结论这些结果表明，外源性维生素E的使用与具有较强的癌症家族风险的女性中结直肠癌风险的降低有关，与散发性结直肠癌病例的人群样本的观察结果一致。使用激素避孕药的潜在年龄效应值得进一步关注。
Objective This work assessed associations between colorectal cancer risk and postmenopausal/contraceptive hormones; subgroup analyses included women with a clinically defined family history of cancer.Methods A population based case-control study of incident colorectal cancer was conducted among women aged 20-74 years in Ontario and Newfoundland & Labrador, Canada. Incident cases (n = 1,404) were selected from provincial cancer registries and controls (n = 1,203) were identified through property records, and other means, between January 1997 and April 2006. Family history of cancer, exogenous hormone-use, and other risk factors were collected via self-administered questionnaires. Multivariate unconditional logistic regression analyses were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs).Results Decreased risks of colorectal cancer were observed with ever-users of: hormonal contraceptives (OR: 0.77; CI: 0.65-0.91), estrogen-only postmenopausal hormones (OR: 0.60; CI: 0.47-0.75), and estrogen-progestin postmenopausal hormones (OR: 0.70; CI: 0.52-0.95). Risk estimates were similar between women with and without a strong familial history of cancer. Age at initiation of hormonal contraceptives was associated with colorectal cancer risk; women who initiated use at younger ages (age < 22 years: OR: 0.60; CI: 0.47-0.77) experienced a greater reduced risk of disease than women who initiated use at later ages (age 30+: OR: 0.92; CI: 0.68-1.24; p(trend): 0.0026).Conclusions These results indicate that exogenous hormone-use is linked with reduced risk of colorectal cancer among women with a strong familial risk of cancer, consistent with observations on population samples of sporadic colorectal cancer cases. A potential age-effect for use of hormonal contraceptives warrants further attention.