Timing of births and endometrial cancer risk in Swedish women.
Timing of births and endometrial cancer risk in Swedish women.
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瑞典女性的出生时间和子宫内膜癌风险。
DOI：
10.1007/s10552-009-9370-7
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发表时间：
2009-10
影响因子：
2.3
通讯作者：
Brinton, Louise A.
中科院分区：
文献类型：
--
作者：
Pfeiffer, Ruth M.;Mitani, Aya;Landgren, Ola;Ekbom, Anders;Kristinsson, Sigurdur Y.;Bjorkholm, Magnus;Biggar, Robert J.;Brinton, Louise A.
虽然生育对子宫内膜癌风险的长期保护作用已经得到了充分的证实，但生育时间的影响尚未完全了解。我们研究了2，674，465名20-72岁瑞典女性的子宫内膜癌风险与生殖特征之间的关系。在1973年至2004年的随访期间，观察到7，386例子宫内膜癌。与单胎女性相比，未生育女性的子宫内膜癌风险显着升高（风险比[HR] = 1.32，95%置信区间[CI]，1.22-1.42）。子宫内膜癌风险随产次增加而降低;与单胎女性相比，生育≥4次的女性HR=0.66（95% CI，0.59-0.74）; p趋势< 0.001。在经产妇女中，我们观察到在调整其他生育因素后，风险与第一次生育的年龄没有关系。虽然我们最初观察到最后一次生育的年龄越大，风险越低，但这似乎反映了自上次生育以来与时间的关系越强，时间较短的女性风险最低。在包括生育次数、首次和末次生育年龄以及自末次生育以来的时间的多产妇女模型中，末次生育年龄与子宫内膜癌风险无关，而自末次生育以来的时间较短和产次增加与统计学显著降低的子宫内膜癌风险相关。与4年内生育的女性相比，自上次生育以来≥25年的女性的HR为3.95（95%CI; 2.17-7.20; p趋势=<0.0001）。我们的研究结果支持，清除启动细胞在分娩过程中可能是重要的子宫内膜癌的发生。
While a protective long-term effect of parity on endometrial cancer risk is well established, the impact of timing of births is not fully understood. We examined the relationship between endometrial cancer risk and reproductive characteristics in a population-based cohort of 2,674,465 Swedish women, 20–72 years of age. During follow-up from 1973 through 2004, 7,386 endometrial cancers were observed. Compared to uniparous women, nulliparous women had a significantly elevated endometrial cancer risk (hazard ratio [HR] = 1.32, 95% confidence interval [CI], 1.22–1.42). Endometrial cancer risk decreased with increasing parity; compared to uniparous women, women with ≥4 births had a HR=0.66 (95% CI, 0.59–0.74); p-trend < 0.001. Among multiparous women, we observed no relationship of risk with age at first birth after adjustment for other reproductive factors. While we initially observed a decreased risk with later ages at last birth, this appeared to reflect a stronger relationship with time since last birth, with women with shorter times being at lowest risk. In models for multiparous women that included number of births, age at first and last birth, and time since last birth, age at last birth was not associated with endometrial cancer risk, while shorter time since last birth and increased parity were associated with statistically significantly reduced endometrial cancer risks. The HR was 3.95 (95%CI; 2.17–7.20; p-trend=<0.0001) for women with ≥25 years since a last birth compared to women having given birth within 4 years. Our findings support that clearance of initiated cells during delivery may be important in endometrial carcinogenesis.
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DOI：
10.1016/s0002-9378(00)70486-8
发表时间：
2000-01-01
影响因子：
9.8
作者：
Parslov, M;Lidegaard, O;Ottesen, B
通讯作者：
Ottesen, B
影响因子：
5
作者：
LESKO, SM;ROSENBERG, L;SHAPIRO, S
通讯作者：
SHAPIRO, S
影响因子：
2
作者：
Thiébaut, ACM;Bénichou, J
通讯作者：
Bénichou, J
影响因子：
168.9
作者：
ADAMI, HO;HSIEH, CC;JANSON, PO
通讯作者：
JANSON, PO
影响因子：
2.3
作者：
Lambe, M;Wuu, J;Hsieh, CC
通讯作者：
Hsieh, CC