Menopausal hormone usage and breast cancer in Saskatchewan: a record-linkage cohort study.
Menopausal hormone usage and breast cancer in Saskatchewan: a record-linkage cohort study.
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萨斯喀彻温省更年期激素的使用与乳腺癌：一项记录关联队列研究。
DOI：
10.1093/oxfordjournals.aje.a117057
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发表时间：
1994
影响因子：
5
通讯作者：
Howe,GR
中科院分区：
文献类型：
--
作者：
Risch,HA;Howe,GR
在使用萨斯喀彻温省健康处方-药物计划数据库的记录-联系研究中，研究了乳腺癌的发生与以前使用更年期雌激素、孕激素和口服避孕药之间的联系。萨斯喀彻温省卫生保健是一个政府机构，为该省基本上所有居民的公共保险医疗保健提供资金。在这项研究中，所有在1976年居住在萨斯喀彻温省的43-49岁的妇女都是从萨斯喀彻温省卫生总登记文件中确定的。这些妇女通过登记受益人编号与1976年1月至1987年6月期间的药物计划数据库和1960年3月至1990年12月期间的省癌症登记数据库联系起来。死亡或从该省移民的事实和日期是通过健康计划的年度更新获得的。在最初进入队列的33,003名女性中，有213名在1976年前被诊断为乳腺癌，因此被排除在这项分析之外。1976至1990年间，新增742例原发乳腺癌病例。服用未被黄体酮反对的雌激素的女性患乳腺癌的风险增加，每使用252片(大约使用1年)，风险增加7%(相对风险=1.072，95%可信区间1.02-1.13；p=0.008)。与孕激素相反的雌激素的使用与风险无关(p=0.48)。在此随访期间，服用口服避孕药的女性风险也更高，每使用252片避孕药，风险增加14%(相对风险=1.144，95%可信区间1.05-1.24；p=0.002)。这些1年风险上升幅度很小，但在较长持续时间内会变得可察觉。例如，使用雌激素5年的相对风险为1.42；使用口服避孕药5年的相对风险为1.96。
The association between the occurrence of carcinoma of the breast and previous usage of menopausal estrogens, progestins, and oral contraceptives is examined in a record-linkage study using the Saskatchewan Health Prescription-Drug-Plan Database. Saskatchewan Health is a governmental agency that funds publicly insured health care for essentially all residents of the province. For this study, all women aged 43–49 years in 1976 resident in Saskatchewan were identified from the Saskatthewan Health master registration file. These women were linked by registration beneficiary number to the Drug-Plan Database for the period from January 1976 to June 1987 and to the Provincial Cancer Registry Database for the period from March 1960 to December 1990. The fact and date of death or emigration from the province were obtained through the annual updates of the health plan. Of the 33,003 women initially in the cohort, 213 had a breast cancer diagnosed before 1976 and were omitted from this analysis. Between 1976 and 1990, 742 new primary breast cancer cases occurred. Women taking estrogens unopposed by progestins had an elevated risk of breast cancer, the risk increasing by 7% (relative risk = 1.072, 95% confidence interval 1.02–1.13;p= 0.008) for each 252 tablets used (approximately 1 year of use). Usage of estrogens opposed by progestins showed no association with risk (p= 0.48). Women taking oral contraceptives during this follow-up period also had a higher risk, increasing by 14% (relative risk = 1.144, 95% confidence interval 1.05–1.24;p= 0.002) for every 252 tablets used. These 1-year risk elevations are small but become appreciable at longer durations. For example, at 5 years of unopposed estrogen use, the relative risk is 1.42; for 5 years of oral contraceptive use, it is 1.96.