Ovulation-stimulation drugs and cancer risks: a long-term follow-up of a British cohort
Ovulation-stimulation drugs and cancer risks: a long-term follow-up of a British cohort
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DOI：
10.1038/sj.bjc.6605086
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发表时间：
2009-05-26
影响因子：
8.8
通讯作者：
MacLean, A. B.
中科院分区：
文献类型：
--
作者：
Silva, I. dos Santos;Wark, P. A.;MacLean, A. B.
为了评估促卵巢药物对健康的长期影响，我们对7355名患有排卵障碍的英国女性进行了20多年的随访，其中43%的人服用促卵巢药物，共发现274例死亡和367例癌症。与一般人群相比，该队列的大多数原因（包括所有肿瘤合并）的死亡率较低，宫颈癌的发病率较低，但乳腺癌（相对危险度：1.13;95% CI 0.97, 1.30）和子宫肌癌（相对危险度：2.02;1.37,2.87）的发病率较高。然而，在服用促卵巢药物的女性和未服用促卵巢药物的女性之间，乳腺癌、子宫、卵巢或任何其他部位的癌症风险没有显著差异。对药物类型和剂量的进一步分析显示，子宫癌风险的剂量-反应梯度（线性趋势P = 0.03），给予>= 2250 mg克罗米芬的妇女与未接受治疗的妇女相比，风险增加2.6倍（2.62;0.94,6.82）。这些发现并不支持促排卵药物与癌症风险之间的强烈联系，但它们表明需要继续监测，以确定某些亚组使用者的风险是否升高。英国癌症杂志（2009）100,1824 -1831。doi: 10.1038 / sj.bjc。6605086 www.bjcancer.com 2009年5月12日(C) 2009年英国癌症研究中心
To assess long-term health effects of ovarian-stimulation drugs we followed-up for over 20 years a British cohort of 7355 women with ovulatory disorders, 43% of whom were prescribed ovarian-stimulation drugs, and identified a total of 274 deaths and 367 incident cancers. Relative to the general population, the cohort experienced lower mortality from most causes, including from all neoplasms combined, and lower incidence of cervical cancer, but higher incidence of cancers of the breast (relative risk: 1.13; 95% CI 0.97, 1.30) and corpus uteri (2.02; 1.37, 2.87). There were, however, no significant differences in the risk of cancers of the breast, corpus uteri, ovary, or of any other site, between women who had been prescribed ovarian-stimulation drugs and those who had not. Further analyses by type of drug and dose revealed a dose-response gradient in the risk of cancer of the corpus uteri (P for linear trend = 0.03), with women given >= 2250 mg of clomiphene having a 2.6-fold (2.62; 0.94, 6.82) increase in risk relative to those who were not treated. These findings do not support strong associations between ovulation-stimulation drugs and cancer risks, but they indicate the need for continued monitoring to establish whether risks are elevated in certain subgroups of users. British Journal of Cancer (2009) 100, 1824-1831. doi: 10.1038/sj.bjc.6605086 www.bjcancer.com Published online 12 May 2009 (C) 2009 Cancer Research UK