TAMOXIFEN THERAPY AND RISK OF REPRODUCTIVE CANCERS

他莫昔芬延长生存期和无复发的成功 乳腺癌患者的存活率启动了对其使用的研究 在乳腺癌的一级预防中。然而，长期的风险 与他莫昔芬治疗相关的药物还没有得到充分的评估， 尤其是关于随后的癌症发生。两者都有 对健康有益和有害的影响都需要很好地记录下来，以便 可以就以下方面作出知情和负责任的决定 预防性治疗。这项以人群为基础的嵌套病例对照研究 将研究他莫昔芬的使用是否是罹患癌症的风险因素 诊断为单侧乳房的妇女的子宫体和/或卵巢 癌症。此外，持续时间和/或近期的变化 他莫昔芬的使用将被检查，因为它与随后的发生有关 原发对侧乳腺癌。 一组被诊断为单侧乳腺癌的女性在1月份 1978年1日和1990年12月31日将从三个城市 被纳入西部癌症监测系统的县 华盛顿，一个以人口为基础的癌症登记机构。后来的女性 患上对侧乳房新的原发恶性肿瘤235例)， 卵巢(n=体部，n=45)自1991年12月31日起将被选为 案子。这一队列中没有第二次发育的女性样本 选择原发恶性肿瘤作为对照。他们将被匹配到 每个病例关于初乳期病例的以下特征 癌症诊断：年龄、绝经状况、癌症分期和年份 诊断。 他莫昔芬治疗和其他治疗信息用于初始 单侧乳腺癌，以及有关其他潜在风险的信息 随后发生新的原发癌症的因素，例如 产次、乳腺癌家族史和既往外源性激素 使用，将通过提取病例的医院病历来获得 和控制，并通过发送给 参与每个病人护理的医生。分析将是 进行的目的是比较两种原发癌症的相对风险 与他莫昔芬的使用关系，针对潜在的混杂进行了调整 特点。 在随机临床试验之前，有必要进行长时间的随访期 可以评估可能与以下疾病相关的罕见继发性癌症的风险 他莫昔芬的使用。拟议的研究可以提供早期结果，将 为广大女性提供有价值的信息，因为她们 考虑预防性使用的风险和好处 他莫昔芬在乳腺癌一级预防中的作用。

The success of tamoxifen in prolonging survival and recurrence-free survival among breast cancer patients has initiated the study of its use in the primary prevention of breast cancer. However, the long-term risks associated with tamoxifen therapy have not been adequately evaluated, particularly with respect to subsequent cancer occurrence. Both beneficial and adverse health effects need to be well documented so that informed and responsible decisions can be made with respect to prophylactic therapy. This population-based, nested case-control study will examine whether tamoxifen use is a risk factor for cancer of the uterine corpus and/or ovary among women diagnosed with unilateral breast cancer. Additionally, the variation in the duration and/or recency of tamoxifen use will be examined as it relates to the subsequent occurrence of primary contralateral breast cancer. A cohort of women diagnosed with unilateral breast cancer between January 1, 1978 and December 31, 1990 will be identified from three urban counties included in the Cancer Surveillance System of western Washington, a population-based cancer registry. Women who subsequently developed a new primary malignancy of the contralateral breast n=235), ovary (n = corpus (n=45) as of December 31, 1991 will be selected as cases. A sample of women in this cohort who did not develop a second primary malignancy will be selected as controls. They will be matched to each case on the following characteristics of the case at initial breast cancer diagnosis: age, menopausal status, stage of cancer, and year of diagnosis. Tamoxifen therapy and other treatment information for the initial unilateral breast cancer, along with information on other potential risk factors for the subsequent new primary cancers of interest, such as parity, a family history of breast cancer, and prior exogenous hormone use, will be obtained by abstracting hospital medical records of cases and controls and through a self-administered questionnaire sent to physicians who were involved in each patients' care. Analyses will be conducted to compare the relative risk of each second primary cancer in relation to use of tamoxifen, adjusted for potentially confounding characteristics. A long follow-up period is necessary before randomized clinical trials can evaluate the risk of rare second cancers potentially associated with tamoxifen use. The proposed study can provide early results that will contribute valuable information to a broad spectrum of women as they consider the risks and benefits associated with prophylactic use of tamoxifen in the primary prevention of breast cancer.