Oral contraceptive use by formulation and endometrial cancer risk among women born in 1947-1964: The Nurses' Health Study II, a prospective cohort study.
Oral contraceptive use by formulation and endometrial cancer risk among women born in 1947-1964: The Nurses' Health Study II, a prospective cohort study.
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DOI：
10.1007/s10654-020-00705-5
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发表时间：
2021-08
影响因子：
13.6
通讯作者：
Fortner RT
中科院分区：
文献类型：
--
作者：
Burchardt NA;Shafrir AL;Kaaks R;Tworoger SS;Fortner RT
口服避孕药（OC）与长期降低子宫内膜癌风险有关；关于与最新 OC 制剂的关联以及与长期风险的关联，人们知之甚少。护士健康研究 II 中共有 107,069 名女性回忆起从 13 岁到基线（1989 年）使用 OC 的情况；每两年更新一次 OC 使用数据，直至 2009 年。根据报告的品牌，按雌激素和孕激素类型、剂量和效力对 OC 进行分类。截至 2017 年，共发现 864 例子宫内膜癌病例。多变量 Cox 比例风险模型估计了 OC 使用与子宫内膜癌风险之间的风险比 (HR) 和 95% 置信区间 [95% CI]。使用 OC 与较低的子宫内膜癌风险相关（曾经使用，HR 0.77 [95% CI 0.65–0.91]；使用 10 年以上，0.43 [0.32–0.58] 与从未使用 OC 相比）。无论自上次使用以来的时间如何，持续时间的负相关都很明显。与从未使用相比，使用乙炔雌二醇 (0.52 [0.41–0.67]) 和第二代孕激素 (0.43 [0.30–0.61]) 的持续时间较长（> 5 年）与美雌醇 (0.66 [0.50–0.88]，p-het = 0.01) 和较低风险的相关性更强。第一代孕激素（0.62 [0.49–0.78]， p-het = 0.03）。除高雌激素和低孕激素剂量外，跨分类累积平均雌激素和孕激素剂量和效力通常观察到负相关（< 与≥中值；曾经使用与从未使用过口服避孕药）。 OC 与较低的子宫内膜癌风险相关，与上次使用后的时间无关。与旧配方相比，使用乙炔雌二醇和第二代孕激素与风险呈更强烈的负相关。在线版本包含可在 10.1007/s10654-020-00705-5 获取的补充材料。
Oral contraceptives (OCs) have been associated with long-term lower endometrial cancer risk; relatively little is known about associations with more recent OC formulations and associations with longer-term risk. A total of 107,069 women from the Nurses’ Health Study II recalled OC use from age 13 to baseline (1989); biennial questionnaires updated data on OC use until 2009. OCs were classified by estrogen and progestin type, dose, and potency based on reported brand. 864 incident endometrial cancer cases were identified through 2017. Multivariable Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals [95% CI] for the association of OC use with endometrial cancer risk. OC use was associated with lower endometrial cancer risk (ever use, HR 0.77 [95% CI 0.65–0.91]; >10 years of use, 0.43 [0.32–0.58] vs. never OC use). Inverse associations for duration were evident regardless of time since last use. Longer durations (> 5 years) of ethinyl estradiol (0.52 [0.41–0.67]) and second-generation progestins (0.43 [0.30–0.61]), both versus never use, were more strongly associated with lower risk than mestranol (0.66 [0.50–0.88], p-het = 0.01) and first-generation progestins (0.62 [0.49–0.78], p-het = 0.03). Inverse associations were generally observed for cross-classified cumulative average estrogen and progestin dose and potency (< vs. ≥ median; ever use vs. never OC use), with the exception of high estrogen and low progestin dose. OCs were associated with lower endometrial cancer risk, independent of time since last use. Use of ethinyl estradiol and second-generation progestins were more strongly inversely associated with risk compared with older formulations. The online version contains supplementary material available at 10.1007/s10654-020-00705-5.
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影响因子：
2
作者：
DURRLEMAN, S;SIMON, R
通讯作者：
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影响因子：
3.8
作者：
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作者：
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作者：
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