Diethylstilbestrol and risk of fatal breast cancer in a prospective cohort of US women
Diethylstilbestrol and risk of fatal breast cancer in a prospective cohort of US women
复制标题
DOI：
10.1093/oxfordjournals.aje.a008976
复制
发表时间：
1996-10-01
影响因子：
5
通讯作者：
Heath, CW
中科院分区：
文献类型：
--
作者：
Calle, EE;Mervis, CA;Heath, CW
作者在一项针对美国成年人的大型前瞻性研究中，研究了怀孕期间使用己烯雌酚与随后发生致命性乳腺癌风险之间的关系。经过9年的随访，在1982年报告无癌症病史的501536名妊娠妇女中观察到1574例致死性乳腺癌。Cox比例风险模型的结果显示，己烯雌酚暴露史（占所有女性的3.9%）与致死性乳腺癌呈正相关（调整后的比率比= 1.34,95%可信区间1.06-1.69）。这种额外的风险并没有随着时间的推移而增加；35年前（比率比= 1.35,95%可信区间0.97-1.87）暴露的妇女的风险并不比过去35年内（比率比= 1.39,95%可信区间1.01-1.93）暴露的妇女高。在25岁之前使用己烯雌酚的女性中没有观察到这种正相关，但在其他所有年龄段都有。研究参与者的年龄并没有改变暴露与乳腺癌之间的联系，并且在分析中没有发现曾经使用己烯雌酚与任何其他潜在危险因素之间有显著的相互作用。这些发现与其他几项关于己烯雌酚暴露与乳腺癌的研究结果一致。
The authors examined the association between the use of diethylstilbestrol during pregnancy and the risk of subsequent fatal breast cancer in a large prospective study of US adults. After 9 years of follow-up, 1,574 cases of fatal breast cancer were observed among 501,536 gravid women who reported no prior history of cancer in 1982. Results from Cox proportional hazards models showed a positive association between a history of diethylstilbestrol exposure (reported by 3.9% of all women) and fatal breast cancer (adjusted rate ratio = 1.34, 95% confidence interval 1.06-1.69). This excess risk did not increase over time; women who were exposed more than 35 years ago (rate ratio = 1.35, 95% confidence interval 0.97-1.87) were not at greater risk than women who were exposed within the past 35 years (rate ratio = 1.39, 95% confidence interval 1.01-1.93). The positive association was not observed in women who used diethylstilbestrol before age 25 years but was seen at all other ages. The age of study participants did not modify the association between exposure and breast cancer, and there were no significant interactions between ever use of diethylstilbestrol and any of the other potential risk factors included in the analysis. These findings are consistent with those of several other studies of diethylstilbestrol exposure and breast cancer.