Breast cancer before age 45 and oral contraceptive use: new findings.
Breast cancer before age 45 and oral contraceptive use: new findings.
复制标题
45 岁之前患乳腺癌和口服避孕药的使用：新发现。
DOI：
--
复制
发表时间：
1989
影响因子：
5
通讯作者：
S. Shapiro
中科院分区：
文献类型：
--
作者：
Donald R. Miller;L. Rosenberg;D. Kaufman;P. Stolley;M. E. Warshauer;S. Shapiro
1983年至1986年，在纽约、费城、巴尔的摩和波士顿进行的一项病例对照研究中，对45岁以前患乳腺癌的风险与口服避孕药的使用之间的关系进行了研究。考虑到混杂因素，对于曾经使用过的患者，多变量相对风险估计值为2.0（95%置信区间（CI），1.4-2.9）。对于使用不到10年，所有持续时间类别的估计值约为2.0，包括不到3个月;对于使用10年或更长时间，估计值为4.1（95% CI，1.8-9.3）。这种关联在几乎所有被检查的亚组中都很明显，包括年轻和老年妇女，以及乳腺癌潜在风险低和高的妇女。与以前的一些报告相反，在第一次怀孕前或早期使用这种关联并不强。结果表明，口服避孕药使用者，特别是那些使用时间很长的人，患乳腺癌的风险可能会增加。然而，不能排除信息偏差，特别是短期使用的信息偏差。如果口服避孕药使用者接受更严格的医疗监督，也可能存在选择偏倚。迄今为止，还不可能调和各种研究的结果，包括作者早期的结果，表明没有关联。后者的结果是从收集的数据使用的方法几乎相同，在本研究中使用的。
The relation between the risk of breast cancer before 45 years of age and oral contraceptive use was examined in a case-control study conducted in New York, Philadelphia, Baltimore, and Boston from 1983 to 1986 of 407 patients with breast cancer and 424 controls. With allowance for confounding, for ever use, the multivariate relative risk estimate was 2.0 (95% confidence interval (CI), 1.4-2.9). For less than 10 years of use, the estimate approximated 2.0 in all categories of duration, including less than three months; for 10 or more years of use it was 4.1 (95% CI, 1.8-9.3). The association was apparent in virtually all subgroups examined, including younger and older women, and women at low and high underlying risk of breast cancer. Contrary to some previous reports, the association was not stronger for use before a first term pregnancy or at an early age. The results suggest that oral contraceptive users, particularly those with very long durations of use, may be at increased risk of breast cancer. However, information bias, particularly for short-term use, could not be ruled out. There may also have been selection bias if oral contraceptive users were under more intensive medical surveillance. It has not been possible to reconcile the findings of the various studies to date, including the authors' earlier results showing no association. The latter results were derived from data collected using methods almost identical to those used in the present study.