MIGRATION PATTERNS AND BREAST-CANCER RISK IN ASIAN-AMERICAN WOMEN
MIGRATION PATTERNS AND BREAST-CANCER RISK IN ASIAN-AMERICAN WOMEN
复制标题
DOI：
10.1093/jnci/85.22.1819
复制
发表时间：
1993-11-17
影响因子：
10.3
通讯作者：
HYER, MB
中科院分区：
文献类型：
--
作者：
ZIEGLER, RG;HOOVER, RN;HYER, MB
背景：历史上，美国的乳腺癌发病率比中国或日本高 4-7 倍，但原因仍然难以捉摸。当中国、日本或菲律宾女性移民到美国时，乳腺癌风险会在几代人的时间内上升，并接近美国白人的风险。目的：我们的目标是量化与亚裔美国女性的各种移民模式相关的乳腺癌风险。方法：1983 年至 1987 年期间，在加利福尼亚州旧金山-奥克兰、加利福尼亚州洛杉矶和夏威夷州瓦胡岛，对年龄为 20-55 岁的中国人、日本人和菲律宾人女性进行了一项基于人群的乳腺癌病例对照研究。我们成功采访了 597 名病例受试者（符合条件的 70%）和 966 名对照受试者（75%）。结果：观察到不同迁移模式的乳腺癌风险呈六倍梯度。在西方出生的亚裔美国女性患乳腺癌的风险比在东方出生的亚裔美国女性高 60%。在西方出生的人中，风险取决于他们的祖父母，尤其是祖母，是出生在东方还是西方。有三到四位祖父母出生在西方的亚裔美国女性，其患病风险比祖父母全部出生在东方的亚裔女性高出 50%。在东部出生的亚裔美国女性中，乳腺癌风险取决于她们移民之前的社区是农村还是城市，以及随后在西部生活的年数。来自城市地区的移民的风险比来自农村地区的移民高30%。在西方生活了 10 年或更长时间的移民的风险比最近的移民高出 80%。对于年龄小于 36 岁的女性移民来说，风险与移民年龄无关。移民一代中种族特定的乳腺癌发病率明显高于原籍国，而在西方出生的亚裔美国人的发病率接近美国白人的发病率。结论：接触西方生活方式对移居美国的亚洲移民一生中患乳腺癌的风险有重大影响。没有直接证据表明在初潮或生育早期存在特别易受影响的时期。意义：由于这些种族人群乳腺癌的异质性与国际比较相似，并且分析流行病学研究提供了理清相关暴露的机会，因此这项研究应该为乳腺癌的病因学提供新的见解。
Background: Breast cancer incidence rates have historically been 4-7 times higher in the United States than in China or Japan, although the reasons remain elusive. When Chinese, Japanese, or Filipino women migrate to the United States, breast cancer risk rises over several generations and approaches that among U.S. Whites. Purpose: Our objective was to quantify breast cancer risks associated with the various migration patterns of Asian-American women. Methods: A population-based, case-control study of breast cancer among women of Chinese, Japanese, and Filipino ethnicities, aged 20-55 years, was conducted during 1983-1987 in San Francisco-Oakland, California, Los Angeles, California, and Oahu, Hawaii. We successfully interviewed 597 case subjects (70% of those eligible) and 966 control subjects (75%). Results: A sixfold gradient in breast cancer risk by migration patterns was observed. Asian-American women born in the West had a breast cancer risk 60% higher than Asian-American women born in the East. Among those born in the West, risk was determined by whether their grandparents, especially grandmothers, were born in the East or the West. Asian-American women with three or four grandparents born in the West had a risk 50% higher than those with all grandparents born in the East. Among the Asian-American women born in the East, breast cancer risk was determined by whether their communities prior to migration were rural or urban and by the number of years subsequently lived in the West. Migrants from urban areas had a risk 30% higher than migrants from rural areas. Migrants who had lived in the West for a decade or longer had a risk 80% higher than more recent migrants. Risk was unrelated to age at migration for women migrating at ages less than 36 years. Ethnic-specific incidence rates of breast cancer in the migrating generation were clearly elevated above those in the countries of origin, while rates in Asian-Americans born in the West approximated the U.S. White rate. Conclusions: Exposure to Western lifestyles had a substantial impact on breast cancer risk in Asian migrants to the United States during their lifetime. There was no direct evidence of an especially susceptible period, during either menarche or early reproductive life. Implications: Because heterogeneity in breast cancer in these ethnic populations is similar to that in international comparisons and because analytic epidemiologic studies offer the opportunity to disentangle correlated exposures, this study should provide new insights into the etiology of breast cancer.