Evidence for a programing effect of early menarche on the rise of breast cancer incidence in Hong Kong
Evidence for a programing effect of early menarche on the rise of breast cancer incidence in Hong Kong
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DOI：
10.1016/j.cdp.2008.05.004
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发表时间：
2008-01-01
影响因子：
--
通讯作者：
Epstein, Richard J.
中科院分区：
文献类型：
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作者：
Leung, Amy W. H.;Mak, Joyce;Epstein, Richard J.
背景资料：初潮年龄较小和首次活产年龄较大是乳腺癌的危险因素，但对这些因素在多大程度上导致发展中国家这一疾病发病率急剧上升的问题，几乎没有进行研究。方法：我们对2003-2006年在香港一家医院诊断的702例连续乳腺癌患者进行了回顾性分析。比较了癌症诊断时不同年龄的患者（因此属于不同的出生队列）及其月经初潮和首次活产时的年龄。然后，我们将这些年龄依赖性差异与香港癌症登记中心的整体乳腺癌发病率数据相关联。结果如下：40岁以前确诊的患者与60岁以后确诊的患者相比，前者月经初潮年龄较低（12.7 vs. 14.2 p < 10（-6）），而首次活产年龄较高（28.2 vs. 25.5; p < 0.01）。然而，登记数据表明，乳腺癌发病率的逐步上升并没有影响到65岁以上的患者，也没有影响到非常年轻的患者（20-39岁）。结论：在香港，生活方式的变化可能会导致初潮年龄的降低，从而增加40岁后诊断为乳腺癌的风险，而早发性癌症可能具有独特的发病机制。尽管是回顾性的，但这些数据提高了癌症预防性健康干预措施可以有效地针对生活在中国等发展中国家的儿童和青少年中有利于初潮的可逆风险因素-如配方婴儿喂养，高脂肪饮食和缺乏锻炼。(C)2008年国际预防肿瘤学会。由爱思唯尔有限公司出版。保留所有权利。
Background: Younger age at menarche and older age at first live birth are implicated as risk factors for breast cancer, but the extent to which these factors contribute to the sharply rising incidence of this disease in developing countries has received little study. Methods: We conducted a retrospective analysis of 702 consecutive breast cancer patients diagnosed at a single hospital in Hong Kong during 2003-2006. Comparisons were made between patients with different ages at cancer diagnosis (hence, belonging to different birth cohorts) and their respective ages at menarche and at first live birth. We then correlated these age-dependent differences with overall breast cancer incidence data from the Hong Kong Cancer Registry. Results: When patients diagnosed before age 40 are compared with those after 60, the age of menarche is lower in the former subgroup (12.7 vs. 14.2 p < 10(-6)) while the age of first live birth is greater (28.2 vs. 25.5; p < 0.01). However, registry data suggest that the progressive rise in breast cancer incidence has not affected those over 65, nor very young (20-39 years) patients. Conclusion: Lifestyle variables that reduce age at menarche may contribute to the rising risk of breast cancer diagnosed after age 40 in Hong Kong, whereas earlier-onset cancers may be characterised by a distinct pathogenesis. Although retrospective, these data raise the possibility that cancer-preventive health interventions could gainfully target reversible risk factors favoring early menarche - such as formula infant feeding, high-fat diets, and lack of exercise - in children and adolescents living in developing countries such as China. (C) 2008 International Society for Preventive Oncology. Published by Elsevier Ltd. All rights reserved.