Endometriosis and the risk of cancer with special emphasis on ovarian cancer
Endometriosis and the risk of cancer with special emphasis on ovarian cancer
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DOI：
10.1093/humrep/dei462
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发表时间：
2006-05-01
影响因子：
6.1
通讯作者：
Bergqvist, A
中科院分区：
文献类型：
--
作者：
Melin, A;Sparén, P;Bergqvist, A
背景：一些关于子宫内膜异位症和癌症共存的观察已经发表。1969年至1986年的一项关于子宫内膜异位症患者的研究显示，总体相对癌症风险为1.2，乳腺癌、卵巢癌和非霍奇金淋巴瘤的相对风险分别为1.3、1.9和1.8。本研究的目的是观察这些风险比是否在一项长期随访的扩展研究中成立。方法：从1969年至2000年诊断为子宫内膜异位症的出院妇女，使用瑞典国家住院患者登记册进行识别。数据与瑞典国家癌症登记册相关联，以确定癌症病例。有关于卵巢切除术和卵巢切除术的数据。计算标准化发病率比（SIR）。结果：64492名女性进入研究。排除第一年的随访，留下3349例癌症病例。癌症的总体风险未增加[SIR 1.04，95% CI 1.00-1.07]。发现卵巢癌（SIR 1.43，95% CI 1.19-1.71）、内分泌肿瘤（SIR 1.36，95% CI 1.15-1.61）、非霍奇金淋巴瘤（SIR 1.24，95% CI 1.02-1.49）和脑肿瘤（SIR 1.22，95% CI 1.04-1.41）的风险升高。早期诊断和长期存在子宫内膜异位症的女性患卵巢癌的风险更高，SIR分别为2.01和2.23。子宫内膜异位症诊断的平均年龄为39.4岁，表明本研究包括中度/重度病例。在子宫内膜异位症诊断之前或诊断时进行子宫切除术的妇女患卵巢癌的风险并没有增加。结论：患有子宫内膜异位症的女性患某些恶性肿瘤的风险增加，特别是卵巢癌，并且风险随着早期诊断或长期疾病而增加。子宫切除术可能对卵巢癌有预防作用。
BACKGROUND: Several observations of the coexistence of endometriosis and cancer have been published. One study concerning endometriosis patients from 1969 to 1986 showed an overall relative cancer risk of 1.2 and relative risks for breast cancer, ovarian cancer and non-Hodgkin's lymphoma to be 1.3, 1.9 and 1.8, respectively. The aim of this study was to see whether these risk ratios stand in an extended study with longer follow-up. METHODS: Women discharged from a hospital, with a diagnosis of endometriosis from 1969 to 2000, were identified using the National Swedish Inpatient Register. Data were linked to the National Swedish Cancer Register to identify cases of cancer. Data on hysterectomies and oophorectomies were available. Standardized incidence ratios (SIR) were calculated. RESULTS: 64 492 women entered the study. First year of follow-up was excluded, leaving 3349 cases of cancer. There was no increased overall risk of cancer [SIR 1.04, 95% CI 1.00-1.07]. Elevated risks were found for ovarian cancer (SIR 1.43, 95% CI 1.19-1.71), endocrine tumours (SIR 1.36, 95% CI 1.15-1.61), non-Hodgkin's lymphoma (SIR 1.24, 95% CI 1.02-1.49) and brain tumours (SIR 1.22, 95% CI 1.04-1.41). Women with early diagnosed and long-standing endometriosis had a higher risk of ovarian cancer, with SIR of 2.01 and 2.23, respectively. The average age at endometriosis diagnosis was 39.4, indicating that there are the moderate/severe cases that are included in this study. Women who had a hysterectomy before or at the time of the endometriosis diagnosis did not show an increased risk of ovarian cancer. CONCLUSION: Women with endometriosis have an increased risk of some malignancies, particularly ovarian cancer, and the risk increases with early diagnosed or long-standing disease. Hysterectomy may have a preventive effect against ovarian cancer.