Tamoxifen exposure and risk of oesophageal and gastric adenocarcinoma: a population-based cohort study of breast cancer patients in Sweden.
Tamoxifen exposure and risk of oesophageal and gastric adenocarcinoma: a population-based cohort study of breast cancer patients in Sweden.
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DOI：
10.1038/sj.bjc.6603214
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发表时间：
2006-07-03
影响因子：
8.8
通讯作者：
Lagergren, J
中科院分区：
文献类型：
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作者：
Chandanos, E;Lindblad, M;Jia, C;Rubio, C A;Ye, W;Lagergren, J
在1961年至2003年瑞典癌症登记处对所有50岁以上患有乳腺癌的妇女进行的一项基于人群的队列研究中，1987年12月31日之前被诊断为未接触他莫昔芬的人被认为没有接触过他莫昔芬，而在该日期之后被诊断出的人被认为有可能接触到他莫昔芬。癌症登记册与死亡和移民登记册之间的相互联系使后续行动成为可能。食道癌和胃癌的标准化发病率(SIRS)代表相对风险。在138名 885队列成员中，我们发现在潜在的三苯氧胺暴露期间(SIR 1.6，95%可信区间(CI)0.83-3.08)，在1 075 724人年的随访中，食管腺癌的风险没有显著增加，但风险估计值随着潜伏期的延长而降低。在未暴露的期间，没有观察到任何关联。在这两个时期中，都没有发现发生贲门腺癌的风险增加。三苯氧胺潜伏期(SIR 1.27，1.03~1.57)和潜伏期最长时期(SIR 1.86，95%CI 1.10~3.14)增加了非贲门部胃腺癌的危险性。相应的总SIR在非暴露组也增加，但此处SIR不随潜伏期延长而增加。与烟草有关的肿瘤的风险增加，即食道鳞状细胞癌和肺癌，仅限于未接触烟草的队列，这表明吸烟的混杂可能解释了未接触烟草期间SIR增加的原因。我们的结论是，他莫昔芬可能与非贲门胃腺癌的风险有关。
In a population-based cohort study of all women aged over 50 years with breast cancer in the Swedish Cancer Register in 1961–2003, those diagnosed before 31 December 1987 were regarded as unexposed to tamoxifen, whereas those diagnosed after that date were considered potentially exposed. Crosslinkages within the Cancer Register and the Registers of Death and Emigration enabled follow-up. Standardised incidence ratios (SIRs) of oesophageal and gastric cancer represented relative risks. Among 138 885 cohort members contributing with 1 075 724 person-years of follow-up, we found a nonsignificantly increased risk of oesophageal adenocarcinoma during the potential tamoxifen exposure period (SIR 1.60, 95% confidence interval (CI) 0.83–3.08), but the risk estimates decreased with increasing latency interval. No association was observed during the unexposed period. No increased risk of cardia adenocarcinoma was identified in either period. The risk of non-cardia gastric adenocarcinoma was increased in the potential tamoxifen period (SIR 1.27, 1.03–1.57), and almost doubled (SIR 1.86, 95% CI 1.10–3.14) in the period of longest latency (10–14 years). The corresponding overall SIR was increased in the unexposed group also, but here SIR did not increase with longer latency intervals. An increased risk of tobacco-related tumours, that is, oesophageal squamous-cell carcinoma and lung cancer, was limited to the unexposed cohort, indicating that confounding by smoking might explain the increased SIR during the unexposed period. We concluded that there might be a link between tamoxifen and risk of non-cardia gastric adenocarcinoma.