Combined estrogen and progestin hormone replacement therapy in relation to risk of breast cancer in middle-aged women.
Combined estrogen and progestin hormone replacement therapy in relation to risk of breast cancer in middle-aged women.
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DOI：
10.1001/jama.1995.03530020055032
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发表时间：
1995-07
期刊：
影响因子：
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通讯作者：
J. Stanford;N. Weiss;L. Voigt;J. Daling;L. Habel;M. Rossing
中科院分区：
文献类型：
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作者：
J. Stanford;N. Weiss;L. Voigt;J. Daling;L. Habel;M. Rossing
目的确定与使用雌激素和孕激素联合激素替代疗法（HRT）相关的乳腺癌风险。设计：以人群为基础的病例对照研究。背景：华盛顿州西部金县的一般女性人口。参与者中年（50 - 64岁）妇女，包括537例在1988年1月1日至1990年6月30日期间诊断为原发性乳腺癌的患者，这些患者通过西雅图-普吉特海峡监测、流行病学和最终结果癌症登记处确定，492例随机选择的对照组妇女没有乳腺癌病史。主要观察指标：绝经期激素使用与乳腺癌风险的关系。结果57.6%的乳腺癌患者和61.0%的对照妇女使用过某种类型的激素。曾服用雌激素-孕酮联合HRT的妇女，占病例的21.5%和对照组的21.3%，患乳腺癌的风险没有增加（相对比值[RO] = 0.9; 95%置信区间[CI]，0.7 - 1.3）。与未使用绝经期激素者相比，使用雌激素-孕酮HRT 8年或更长时间者患乳腺癌的风险降低（RO = 0.4; 95%CI，0.2 - 1.0）。结论：总的来说，雌激素联合雌激素替代疗法与中年妇女乳腺癌风险增加无关。尽管如此，由于联合使用雌激素-孕激素替代疗法只是最近才变得普遍，未来的调查必须评估是否乳腺癌的发病率改变后多年雌激素-孕激素替代疗法已经开始，特别是在长期用户。
OBJECTIVE To determine the risk of breast cancer in relation to the use of combined estrogen and progestin hormone replacement therapy (HRT). DESIGN A population-based case-control study. SETTING The general female population of King County in western Washington State. PARTICIPANTS Middle-aged (50 to 64 years) women, including 537 patients with incident primary breast cancer diagnosed between January 1, 1988, and June 30, 1990, who were ascertained through the Seattle-Puget Sound Surveillance, Epidemiology, and End Results cancer registry and 492 randomly selected control women without a history of breast cancer. MAIN OUTCOME MEASURE Breast cancer risk in relation to use of menopausal hormones. RESULTS Menopausal hormones of some type had been used by 57.6% of breast cancer cases and 61.0% of comparison women. The women who had ever taken combined estrogen-progestin HRT, representing 21.5% of cases and 21.3% of controls, were not at increased risk of breast cancer (relative odds [RO] = 0.9; 95% confidence interval [CI], 0.7 to 1.3). Compared with nonusers of menopausal hormones, those who used estrogen-progestin HRT for 8 or more years had, if anything, a reduced risk of breast cancer (RO = 0.4; 95% CI, 0.2 to 1.0). CONCLUSIONS On the whole, the use of estrogen with progestin HRT does not appear to be associated with an increased risk of breast cancer in middle-aged women. Nonetheless, since the use of combined estrogen-progestin HRT has only recently become prevalent, future investigations must assess whether breast cancer incidence is altered many years after estrogen-progestin HRT has been initiated, particularly among long-term users.