Breast cancer risk in relation to the interval between menopause and starting hormone therapy.
Breast cancer risk in relation to the interval between menopause and starting hormone therapy.
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DOI：
10.1093/jnci/djq527
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发表时间：
2011-02-16
期刊：
影响因子：
--
通讯作者：
Million Women Study Collaborators
中科院分区：
文献类型：
--
作者：
Beral V;Reeves G;Bull D;Green J;Million Women Study Collaborators
尽管使用雌激素-孕激素的人患乳腺癌的风险比只使用雌激素的更年期激素疗法的患者更高，但关于它们的影响的报道有些不一致。我们调查了这些治疗的时机是否会影响乳腺癌的发病率。共有1名 129名 025名绝经后英国妇女提供了有关激素治疗使用和其他与乳腺癌风险相关因素的前瞻性信息。我们使用COX回归来估计激素治疗使用者与从不使用激素治疗使用者的乳腺癌的调整后相对危险度(RR)，并计算标准化发病率。所有的统计检验都是双面的。在405万妇女年的随访中，发生了15起 759起乳腺癌事件，其中7107起是目前使用激素治疗的患者。在目前使用激素治疗的人中，乳腺癌的发病率增加，在停止使用几年后，恢复到从未使用过的人的水平。在目前的使用者中，如果激素治疗是在绝经前或绝经后不久开始的，那么患乳腺癌的相对风险比间隔较长的时间后更大(对于仅使用雌激素和雌激素-孕激素配方的患者来说，P异质性)。在目前的纯雌激素制剂使用者中，如果在绝经后5年或更长时间开始使用，风险几乎或没有增加(RR=1.05，95%可信区间[CI]=0.89至1.24)，但如果在绝经前或绝经后5年内开始使用，风险显著增加(RR=1.43，95%CI=1.35至1.51)。在目前使用雌孕激素制剂的人群中也观察到了类似的情况(RR=1.53，95%CI=1.38~1.70；RR=2.04，95%CI=1.95~2.14)。在50-59岁，从未使用激素治疗的乳腺癌的年标化发病率为0.30%(95%CI=0.29%~0.31%)，在绝经后5年内开始使用雌激素和雌孕激素制剂的现有使用者中，乳腺癌的年标化发病率分别为0.43%(95%CI=0.42%~0.45%)和0.61%(95%CI=0.59%~0.64%)。在目前使用激素治疗的患者中，乳腺癌风险有很大的异质性。使用雌激素-孕激素的人比只服用雌激素的人风险更大，如果激素治疗在绝经前后开始比更晚。
Although breast cancer risk is greater in users of estrogen–progestin than estrogen-only formulations of menopausal hormonal therapy, reports on their effects have been somewhat inconsistent. We investigated whether the timing of these therapies affected breast cancer incidence. A total of 1 129 025 postmenopausal UK women provided prospective information on hormonal therapy use and other factors relevant for breast cancer risk. We used Cox regression to estimate adjusted relative risks (RRs) of breast cancer in hormonal therapy users vs never users and calculated standardized incidence rates. All statistical tests were two-sided. During 4.05 million woman-years of follow-up, 15 759 incident breast cancers occurred, with 7107 in current users of hormonal therapy. Breast cancer incidence was increased in current users of hormonal therapy, returning to that of never users a few years after use had ceased. The relative risks for breast cancer in current users were greater if hormonal therapy was begun before or soon after menopause than after a longer gap (Pheterogeneity < .001, for both estrogen-only and estrogen-progestin formulations). Among current users of estrogen-only formulations, there was little or no increase in risk if use began 5 years or more after menopause (RR = 1.05, 95% confidence interval [CI] = 0.89 to 1.24), but risk was statistically significantly increased if use began before or less than 5 years after menopause (RR = 1.43, 95% CI = 1.35 to 1.51). A similar pattern was observed among current users of estrogen–progestin formulations (RR = 1.53, 95% CI = 1.38 to 1.70, and RR = 2.04, 95% CI = 1.95 to 2.14, respectively). At 50–59 years of age, annual standardized incidence rates for breast cancer were 0.30% (95% CI = 0.29% to 0.31%) among never users of hormone therapy and 0.43% (95% CI = 0.42% to 0.45%) and 0.61% (95% CI = 0.59% to 0.64%), respectively, among current users of estrogen-only and estrogen–progestin formulations who began use less than 5 years after menopause. There was substantial heterogeneity in breast cancer risk among current users of hormonal therapy. Risks were greater among users of estrogen–progestin than estrogen-only formulations and if hormonal therapy started at around the time of menopause than later.
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影响因子：
3.8
作者：
Chiarelli, Anna M.;Kirsh, Victoria A.;Boyd, Norman F.
通讯作者：
Boyd, Norman F.
影响因子：
120.7
作者：
Reeves, Gillian K.;Travis, Ruth C.;Lathrop, Mark
通讯作者：
Lathrop, Mark
影响因子：
45.3
作者：
Fournier, Agnes;Mesrine, Sylvie;Clavel-Chapelon, Francoise
通讯作者：
Clavel-Chapelon, Francoise
雌激素加孕激素与绝经后妇女乳腺癌的发病率和死亡率。
DOI：
10.1001/jama.2010.1500
发表时间：
2010-10-20
期刊：
JAMA
影响因子：
--
作者：
Chlebowski RT;Anderson GL;Gass M;Lane DS;Aragaki AK;Kuller LH;Manson JE;Stefanick ML;Ockene J;Sarto GE;Johnson KC;Wactawski-Wende J;Ravdin PM;Schenken R;Hendrix SL;Rajkovic A;Rohan TE;Yasmeen S;Prentice RL;WHI Investigators
通讯作者：
WHI Investigators
影响因子：
120.7
作者：
Anderson, GL;Limacher, M;Wassertheil-Smoller, S
通讯作者：
Wassertheil-Smoller, S