REPRODUCTIVE, MENSTRUAL, AND MEDICAL RISK-FACTORS FOR ENDOMETRIAL CANCER - RESULTS FROM A CASE-CONTROL STUDY
REPRODUCTIVE, MENSTRUAL, AND MEDICAL RISK-FACTORS FOR ENDOMETRIAL CANCER - RESULTS FROM A CASE-CONTROL STUDY
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DOI：
10.1016/s0002-9378(11)91709-8
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发表时间：
1992-11-01
影响因子：
9.8
通讯作者：
HOOVER, RN
中科院分区：
文献类型：
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作者：
BRINTON, LA;BERMAN, ML;HOOVER, RN
目的：我们的目的是评估子宫内膜癌的风险与生殖、月经和医学因素的关系。研究设计：对美国5个地区405例子宫内膜癌病例和297例人群对照进行病例对照研究，以评估风险。结果：无妊娠史是主要的危险因素（相对危险度为2.8,95%可信区间为1.7 ~ 4.6）。怀孕的保护作用似乎反映了足月分娩的影响，因为自然流产和人工流产是不相关的风险。在未生育妇女中，不孕症是一个重要因素，寻求医疗建议的妇女怀孕的风险几乎是没有困难的妇女的八倍。在调整了其他生殖特征后，首次生育的年龄和母乳喂养的持续时间与风险无关。结论：报告初潮年龄较早（< 12岁相对风险为2.4，大于等于15岁相对风险为2.4）和月经来潮天数较长（大于等于7天相对风险为1.9，小于等于4天）的受试者风险较高，但与自然绝经年龄较晚无关。身高与风险无关，但与体重有显著关系，200磅与< 125磅的风险为7.2（95%置信区间为3.9至13.3）。在调整体重和其他因素后，高血压病史和胆囊疾病与风险无显著相关，但糖尿病的影响持续存在（相对危险度2.0,95%可信区间1.1 - 3.6）。老年多毛症的发生也有显著相关性（相对危险度2.0,95%可信区间1.2 ~ 3.4）。
OBJECTIVE: Our objective was to evaluate the risk for endometrial cancer in relation to reproductive, menstrual, and medical factors.STUDY DESIGN: A case-control study of 405 endometrial cancer cases and 297 population controls in five areas of the United States enabled risk to be evaluated.RESULTS: A major risk factor was the absence of prior pregnancy (relative risk 2.8, 95% confidence interval 1.7 to 4.6). The protective effect of pregnancy appeared to reflect the influence of term births, because spontaneous and induced abortions were unrelated risk. Among nulliparous women infertility was a significant factor, with women having sought medical advice having nearly eight times the risk of those without difficulty conceiving. After adjustment for other reproductive characteristics, age at first birth and duration of breast-feeding were not related to risk.CONCLUSIONS: Elevated risks were found for subjects reporting early ages at menarche (relative risk 2.4 for ages < 12 vs greater-than-or-equal-to 15) and longer days of flow (relative risk 1.9 for greater-than-or-equal-to 7 vs < 4 days), but there was no relationship with late ages at natural menopause. Height was not associated with risk, but there was a significant relation to weight, with the risk for 200 versus < 125 pounds being 7.2 (95% confidence interval 3.9 to 13.3). After adjustment for weight and other factors, histories of hypertension and gallbladder disease were not significantly related to risk, but an effect of diabetes persisted (relative risk 2.0, 95% confidence interval 1.1 to 3.6). Hirsutism developing at older ages was also significantly related (relative risk 2.0, 95% confidence interval 1.2 to 3.4).