Effect of Depo-Medroxyprogesterone Acetate on Breast Cancer Risk among Women 20 to 44 Years of Age
Effect of Depo-Medroxyprogesterone Acetate on Breast Cancer Risk among Women 20 to 44 Years of Age
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DOI：
10.1158/0008-5472.can-11-4064
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发表时间：
2012-04-15
期刊：
影响因子：
11.2
通讯作者：
Malone, Kathleen E.
中科院分区：
文献类型：
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作者：
Li, Christopher I.;Beaber, Elisabeth F.;Malone, Kathleen E.
醋酸甲羟孕酮(DMPA)是一种注射避孕药，含有与更年期激素疗法相同的孕激素，在妇女健康倡议临床试验中发现，这种疗法会增加绝经后女性患乳腺癌的风险。然而，很少有研究评估DMPA的使用与乳腺癌风险的关系。在这里，我们对1028名年龄在20岁至44岁的女性进行了一项基于人群的病例对照研究，以评估DMPA的使用与乳腺癌风险之间的关系。有关DMPA使用和其他相关协变量的详细信息是通过结构化的面试者亲自管理的问卷获得的，并使用非条件Logistic回归来评估DMPA使用的各个方面与乳腺癌风险之间的关联。我们发现，最近使用DMPA 12个月或更长时间与浸润性乳腺癌风险增加2.2倍[95%可信区间(CI)1.2-4.2]相关。这种风险并不因肿瘤分期、大小、激素受体表达或组织学亚型而有显著差异。虽然乳腺癌在年轻女性中很少见，而且在停止使用DMPA后，与DMPA相关的乳腺癌风险似乎消失了，但我们的研究结果强调了鉴于可用替代品的数量，确定与特定形式避孕药相关的潜在风险的重要性。癌症资源；72(8)；2028-35。(C)2012年AACR。
Depo-medroxyprogesterone acetate (DMPA) is an injectable contraceptive that contains the same progestin as the menopausal hormone therapy regimen found to increase breast cancer risk among postmenopausal women in the Women's Health Initiative clinical trial. However, few studies have evaluated the relationship between DMPA use and breast cancer risk. Here, we conducted a population-based case-control study among 1,028 women ages 20 to 44 years to assess the association between DMPA use and breast cancer risk. Detailed information on DMPA use and other relevant covariates was obtained through structured interviewer-administered in-person questionnaires, and unconditional logistic regression was used to evaluate associations between various aspects of DMPA use and breast cancer risk. We found that recent DMPA use for 12 months or longer was associated with a 2.2-fold [95% confidence interval (CI), 1.2-4.2] increased risk of invasive breast cancer. This risk did not vary appreciably by tumor stage, size, hormone receptor expression, or histologic subtype. Although breast cancer is rare among young women and the elevated risk of breast cancer associated with DMPA appears to dissipate after discontinuation of use, our findings emphasize the importance of identifying the potential risks associated with specific forms of contraceptives given the number of available alternatives. Cancer Res; 72(8); 2028-35. (C) 2012 AACR.