The risk of cancer and the role of parity among women with endometriosis
The risk of cancer and the role of parity among women with endometriosis
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DOI：
10.1093/humrep/dem209
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发表时间：
2007-11-01
影响因子：
6.1
通讯作者：
Bergqvist, A.
中科院分区：
文献类型：
--
作者：
Melin, A.;Sparen, P.;Bergqvist, A.
背景：一些流行病学研究表明子宫内膜异位症妇女患癌症的风险增加，尤其是卵巢癌。不育和未生育也是已知的不同类型癌症的风险因素。本研究的目的是调查子宫内膜异位症妇女患癌症的风险，对产次进行分层。方法：从1969年至2002年诊断为子宫内膜异位症的出院妇女，使用瑞典国家住院患者登记册进行识别。数据与瑞典国家癌症登记册相关联，以确定癌症病例，并与瑞典多代登记册相关联，以计算第一胎的产次和年龄。计算标准化发病率比（SIR）。结果：共有63630名女性进入研究。为了排除子宫内膜异位症诊断时已经存在的癌症，排除了第一年的随访，留下了3822例癌症病例。子宫内膜异位症妇女患癌症的总体风险没有增加（SIR 1.01）。子宫内膜异位症与内分泌肿瘤（SIR 1.38）、卵巢癌（SIR 1.37）、肾癌（SIR 1.36）、甲状腺癌（SIR 1.33）、脑肿瘤（SIR 1.27）、恶性黑色素瘤（SIR 1.23）和乳腺癌（SIR 1.08）的风险升高相关，宫颈癌风险降低（SIR 0.71）。在子宫内膜异位症患者中，未经产和经产的任何一种癌症的患病风险均无显著差异。子宫内膜异位症妇女患卵巢癌的风险随着产次的增加而无显著性降低。结论：子宫内膜异位症的妇女有几种恶性肿瘤的风险增加。风险的增加似乎与平价无关。
BACKGROUND: Several epidemiological studies have shown an increased cancer risk among women with endometriosis, especially ovarian cancer. Infertility and nulliparity are also known risk factors for different types of cancer. The aim of this study is to investigate cancer risk among women with endometriosis, stratifying for parity. METHODS: Women discharged from a hospital, with the diagnosis of endometriosis from 1969 to 2002, were identified using the National Swedish Inpatient Register. Data were linked to the National Swedish Cancer Register to identify cases of cancer and to the Swedish Multi-Generation Register to calculate parity and age at first birth. Standardized incidence ratios (SIR) were calculated. RESULTS: A total of 63 630 women entered the study. To exclude cancers already present at the time of endometriosis diagnosis, the first year of follow-up was excluded, leaving a number of 3822 cases of cancer. There was no increased overall risk of cancer (SIR 1.01) among women with endometriosis. Endometriosis was associated with elevated risks for endocrine tumours (SIR 1.38), ovarian cancer (SIR 1.37), renal cancer (SIR 1.36), thyroid cancer (SIR 1.33), brain tumours (SIR 1.27), malignant melanoma (SIR 1.23) and breast cancer (SIR 1.08), as well as a reduced risk for cervical cancer (SIR 0.71). There were no significant differences between nulliparous and parous women with endometriosis regarding cancer risk for any of the cancer types. There was a non-significant decrease in risk of ovarian cancer with increasing parity for women with endometriosis. CONCULSIONS: Women with endometriosis have an increased risk for several malignancies. The increased risks do not seem to be related to parity.