Smoking and the risk of endometrial cancer: results from the Nurses' Health Study.
Smoking and the risk of endometrial cancer: results from the Nurses' Health Study.
复制标题
吸烟与子宫内膜癌的风险：护士健康研究的结果。
DOI：
10.1002/ijc.20821
复制
发表时间：
2005
影响因子：
6.4
通讯作者：
Hankinson,SusanE
中科院分区：
文献类型：
--
作者：
Viswanathan,AkilaN;Feskanich,Diane;DeVivo,Immaculata;Hunter,DavidJ;Barbieri,RobertL;Rosner,Bernard;Colditz,GrahamA;Hankinson,SusanE
吸烟与子宫内膜癌呈负相关，主要发生在当前吸烟者中。为了评估这种关联，我们分析了前瞻性护士健康研究的数据。从1976年到2000年，在180万人年的随访中发现了702例浸润性子宫内膜癌。吸烟状况于1976年进行评估，每两年更新一次。采用Cox比例风险模型计算多因素相对危险度（rr），控制子宫内膜癌危险因素。与从不吸烟者相比，当前吸烟者（RR = 0.63; 95% CI = 0.50-0.79）和过去吸烟者（RR = 0.73; 95% CI = 0.62-0.87）患子宫内膜癌的多变量RR均显著降低。当额外调整身体质量指数（BMI）时，当前吸烟者的RR减弱（RR = 0.72; 95% CI = 0.57-0.90），但过去吸烟者的RR没有变化。每天吸烟35支或以上的女性（RR = 0.60; 95% CI = 0.39-0.91）和吸烟40年或以上的女性（RR = 0.63; 95% CI = 0.45-0.87）的风险较低。趋势测试排除了从不吸烟的人，对分析的任何吸烟变量都没有统计学意义。这些数据表明，现在和过去吸烟与子宫内膜癌的风险较低有关。这一发现提供了对疾病病因的深入了解，并表明吸烟对子宫内膜癌风险的影响甚至发生在成年早期，而且是长期的，可能不仅仅归因于短期的激素调节。©2004 Wiley‐Liss, Inc。
An inverse association between smoking and endometrial cancer has generally been observed, primarily among current smokers. To assess this association, we analyzed data from the prospective Nurses' Health Study. From 1976 to 2000, 702 cases of invasive endometrial cancer were identified during 1.8 million person‐years of follow‐up. Smoking status was assessed in 1976 and updated every 2 years. Cox proportional hazards models were used to calculate multivariate relative risks (RRs), controlling for endometrial cancer risk factors. Compared to never smokers, the multivariate RR of endometrial cancer was significantly lower among both current smokers (RR = 0.63; 95% CI = 0.50–0.79) and past smokers (RR = 0.73; 95% CI = 0.62–0.87). When additionally adjusting for body mass index (BMI), the RR for current smokers was attenuated (RR = 0.72; 95% CI = 0.57–0.90), but the RR for past smokers did not change. Risk was lower among women who smoked 35 or more cigarettes a day (RR = 0.60; 95% CI = 0.39–0.91) and among those who smoked for 40 or more years (RR = 0.63; 95% CI = 0.45–0.87). Tests for trend, which excluded never smokers, were not statistically significant for any of the smoking variables analyzed. These data indicate that both current and past smoking are associated with a lower risk of endometrial cancer. The findings provide insight into disease etiology and suggest that the influence of smoking on endometrial cancer risk occurs even in early adulthood, is long‐lasting, and may not be attributed solely to short‐term hormonal modulation. © 2004 Wiley‐Liss, Inc.