Differential effects of reproductive factors on the risk of pre- and postmenopausal breast cancer. Results from a large cohort of French women.
Differential effects of reproductive factors on the risk of pre- and postmenopausal breast cancer. Results from a large cohort of French women.
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DOI：
10.1038/sj.bjc.6600124
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发表时间：
2002-03-04
影响因子：
8.8
通讯作者：
Clavel-Chapelon, F
中科院分区：
文献类型：
--
作者：
Clavel-Chapelon, F
这项研究的目的是为了更好地了解激素因素在乳腺癌风险中的作用，并确定生殖事件的影响是否因诊断年龄的不同而不同。该研究分析了初潮年龄、首次足月妊娠年龄、足月妊娠次数和自然流产次数对乳腺癌总体风险及其绝经前或绝经后发病的影响，使用了1718例乳腺癌病例的数据，这些数据来自参加E3N队列研究的约10万名法国妇女的大样本。研究结果进一步证明，乳腺癌的总体风险随着初潮年龄的降低、首次怀孕年龄的增加和胎次过低而增加。未观察到自然流产的总体效果。这些生殖因素的影响因绝经状态而异。初潮年龄对绝经前乳腺癌风险有影响，随着年龄的增加，风险每年降低7% （P<0.05）。与第一次月经在11岁或之前的女性相比，绝经前组在15岁或之后经历月经初潮的女性的RR为0.66 （95% CI 0.45-0.97）。首次足月妊娠的年龄对绝经前和绝经后患乳腺癌的风险都有影响，有意义的测试显示，随着年龄的增加，风险逐年增加（P分别=0.001和P<0.05）。30岁以上首次足月妊娠的绝经前组和绝经后组的风险分别为1.63 （95% CI 1.12-2.38）和1.35 （95% CI 1.02-1.78）。高胎次仅对绝经后乳腺癌风险有保护作用（趋势检验P =0.001）， 1、2、3、4个或更多足月妊娠的点估计值分别为0.79 （95% CI 0.60-1.04）、0.69 （95% CI 0.54-0.88）、0.66 （95% CI 0.51-0.85）和0.64 （95% CI 0.48-0.86）。自然流产史对绝经前后诊断的乳腺癌风险没有显著影响。我们的研究结果表明，生育事件对乳腺癌的风险有复杂的影响。英国癌症杂志（2002）86,723-727。DOI: 10.1038/sj/bjc/6600124 www.bjcancer.com©2002英国癌症研究中心
The aim of this study was to obtain a better understanding of the role of hormonal factors in breast cancer risk and to determine whether the effect of reproductive events differs according to age at diagnosis. It analysed the effect of age at menarche, age at first full-term pregnancy, number of full-term pregnancies and number of spontaneous abortions both on the overall risk of breast cancer and on its pre- or postmenopausal onset, using the data on 1718 breast cancer cases, obtained from a large sample of around 100 000 French women participating in the E3N cohort study. The results provide further evidence that the overall risk of breast cancer increases with decreasing age at menarche, increasing age at first pregnancy and low parity. No overall effect of spontaneous abortions was observed. The effect of these reproductive factors differed according to menopausal status. Age at menarche had an effect on premenopausal breast cancer risk, with a decrease in risk with increasing age of 7% per year (P<0.05). Compared to those who had their first menstrual periods at 11 or before, women experiencing menarche at 15 or after had an RR of 0.66 (95% CI 0.45–0.97) in the premenopausal group. Age at first full-term pregnancy had an effect on both pre- and postmenopausal breast cancer risk, with significant tests showing increasing risk per year of increasing age (P=0.001 and P<0.05 respectively). A first full-term pregnancy above age 30 conveyed a risk of 1.63 (95% CI 1.12–2.38) and 1.35 (95% CI 1.02–1.78) in the pre- and postmenopausal groups respectively. A protective effect of high parity was observed only for postmenopausal breast cancer risk (P for trend test =0.001), with point estimates of 0.79 (95% CI 0.60–1.04), 0.69 (95% CI 0.54–0.88), 0.66 (95% CI 0.51–0.85) and 0.64 (95% CI 0.48–0.86) associated to a one, two, three and four or more full-term pregnancies. A history of spontaneous abortion had no significant effect on the risk of breast cancer diagnosed before or after menopause. Our results suggest that reproductive events have complex effects on the risk of breast cancer. British Journal of Cancer (2002) 86, 723–727. DOI: 10.1038/sj/bjc/6600124 www.bjcancer.com © 2002 Cancer Research UK
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