THERAPEUTIC AND DIAGNOSTIC FACTORS AS RELATED TO CANCER RISK

继续保持对两国关系的长期兴趣 医源性药物对癌症风险，研究检查了口服的效果 避孕药、更年期激素和不孕药。在一个 国际合作，口服避孕药显示增加 乳腺癌风险只对最近的使用者，随着影响的消散 五年或更长时间后。病例对照研究中的进一步分析 详细说明与口腔相关的高风险原因 35岁前确诊乳腺癌的避孕药具 表明更多的注意力应该集中在潜在的与 种族、家族史和酒精饮料消费。在后续行动中 乳腺癌筛查参与者的研究，既不是口头的 避孕药和更年期激素似乎都会影响患糖尿病的风险。 随后的结直肠癌。一大批瑞典人的随访 服用更年期荷尔蒙的女性患病风险显著增加 使用雌激素后子宫内膜癌的风险；女性处方 联合治疗没有改变子宫内膜癌的风险，但确实改变了 在10岁以上患乳腺癌的风险增加约40% 多年的跟踪调查。相比之下，结直肠癌和肝脏的风险降低 观察肿瘤的发生。与荷尔蒙有关的各种原因的死亡率 在这项研究中也检查了使用情况。同样令人担忧的是， 促排卵药物可能会增加某些癌症的风险， 尤其是卵巢癌。为了解决这些问题，一场回顾 已经启动了对10,000名不孕妇女的队列研究。癌症风险 与医疗器械有关的问题也引起了人们的兴趣。使用 宫内节育器，特别是惰性节育器，似乎可以减少 患子宫内膜癌的风险。尽管隆胸手术已经被证明可以 干扰乳房病变的乳房X光显影， 病例对照研究发现，它们与降低乳腺癌风险有关， 与早先的几项前瞻性研究一致。大号 对13,000名接受美容植入物的女性进行了回顾性队列研究 目前正在进行以确定不同的植入物是否易于 各种形式的癌症以及结缔组织疾病； 人们对癌症风险的兴趣是硅胶植入物 NCI实验室最近提出的多发性骨髓瘤易感性 调查结果。

Continuing with a long-standing interest in the relationship of iatrogenic agents to cancer risk, studies examined effects of oral contraceptives, menopausal hormones, and infertility drugs. In an international collaboration, oral contraceptives were shown to increase breast cancer risk only for recent users, with the effect dissipating after five or more years. Further analyses within a case-control study to elaborate on reasons for the high risk associated with oral contraceptives for breast cancers diagnosed prior to 35 years of age showed that further attention should focus on potential interactions with race, family history, and alcoholic beverage consumption. In a follow-up study of breast cancer screening participants, neither oral contraceptives nor menopausal hormones appeared to affect the risk of subsequent colorectal cancers. Follow-up of a large cohort of Swedish women prescribed menopausal hormones showed a significant increased risk of endometrial cancer following estrogen use; women prescribed combination therapy were not at altered endometrial cancer risk, but did experience approximately a 40% elevated risk of breast cancer after 10 years of follow-up. In contrast, reduced risks of colorectal and liver cancers were observed. Mortality from all causes in relation to hormone use was also examined in this study. Also of concern is whether ovulation-stimulating drugs might increase the risk of certain cancers, particularly ovarian cancer. To address these concerns, a retrospective cohort study of 10,000 infertile women has been initiated. Cancer risk in relation to medical devices has also been of interest. Use of intra-uterine devices, particularly inert ones, appeared to reduce the risk of endometrial cancer. Although breast implants have been shown to interfere with mammographic visualization of breast lesions, a case-control study found them associated with reduced breast cancer risk, consistent with several earlier prospective studies. A large retrospective cohort study of 13,000 women with cosmetic implants is currently underway to ascertain whether different implants predispose to various forms of cancer as well as connective tissues disorders; of interest with respect to cancer risk is whether silicone implants predispose to multiple myeloma, as suggested by recent NCI laboratory findings.