Cancer Risk After Exposure to Treatments for Ovulation Induction
Cancer Risk After Exposure to Treatments for Ovulation Induction
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DOI：
10.1093/aje/kwn318
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发表时间：
2009-02-01
影响因子：
5
通讯作者：
Paltiel, O.
中科院分区：
文献类型：
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作者：
Calderon-Margalit, R.;Friedlander, Y.;Paltiel, O.
促排卵治疗是否与癌症风险增加有关仍不确定。作者对生育妇女进行了一项长期以人群为基础的历史队列研究。在耶路撒冷围产期研究中，共有15030名1974-1976年间分娩的妇女参加了一项产后调查。在控制了年龄和其他协变量的情况下，使用Cox比例风险模型分析了2004年的癌症发病率。使用药物促排卵的妇女（n = 567）在任何部位的癌症风险都增加(多因素风险比（HR) = 1.36, 95%可信区间（CI）： 1.06, 1.74）。使用促排卵药物的妇女患子宫癌的风险增加（HR = 3.39, 95% CI: 1.28, 8.97），特别是克罗米芬（HR 4.56, 95% CI: 1.56, 13.34）。使用促排卵药物与卵巢癌之间没有关联（年龄调整后HR = 0.61, 95% CI: 0.08, 4.42）。排卵诱导与乳腺癌危险显著增加相关（多变量HR = 1.42, 95% CI: 0.99, 2.05）。恶性黑色素瘤和非霍奇金淋巴瘤的风险也有所增加。这些关联在等待1年以上怀孕的女性中表现得更强。需要进一步的随访研究，根据药物类型、剂量和持续时间来评估这些关联。
Uncertainty continues as to whether treatments for ovulation induction are associated with increased risk of cancer. The authors conducted a long-term population-based historical cohort study of parous women. A total of 15,030 women in the Jerusalem Perinatal Study who gave birth in 1974-1976 participated in a postpartum survey. Cancer incidence through 2004 was analyzed using Cox's proportional hazards models, controlling for age and other covariates. Women who used drugs to induce ovulation (n = 567) had increased risks of cancer at any site (multivariate hazard ratio (HR) = 1.36, 95% confidence interval (CI): 1.06, 1.74). An increased risk of uterine cancer was found among women treated with ovulation-inducing agents ( HR = 3.39, 95% CI: 1.28, 8.97), specifically clomiphene (HR 4.56, 95% CI: 1.56, 13.34). No association was noted between use of ovulation-inducing agents and ovarian cancer (age-adjusted HR = 0.61, 95% CI: 0.08, 4.42). Ovulation induction was associated with a borderline-significant increased risk of breast cancer ( multivariate HR = 1.42, 95% CI: 0.99, 2.05). Increased risks were also observed for malignant melanoma and non-Hodgkin lymphoma. These associations appeared stronger among women who waited more than 1 year to conceive. Additional follow-up studies assessing these associations by drug type, dosage, and duration are needed.