THERAPEUTIC AND DIAGNOSTIC FACTORS AS RELATED TO CANCER RISK

长期以来， 医源性药物对癌症风险的影响，研究检查了口服 避孕药、更年期激素和不孕症药物。 中 国际合作，口服避孕药被证明是增加 乳腺癌的风险只针对最近的用户，随着影响的消失， 五年或更长时间后。 病例对照研究中的进一步分析 详细说明与口服避孕药相关的高风险的原因， 35岁以前诊断出乳腺癌的避孕药 表明，进一步的注意力应集中在潜在的相互作用， 种族、家族史和酒精饮料消费。 新闻和跟踪 乳腺癌筛查参与者的研究， 避孕药和更年期激素似乎会影响 结直肠癌。 一个大型瑞典队列的随访 服用更年期激素的妇女， 使用雌激素后子宫内膜癌;女性处方 联合治疗没有改变子宫内膜癌的风险，但 10岁以后患乳腺癌的风险增加约40% 多年的后续。 相比之下，结肠直肠和肝脏的风险降低 观察了癌症。 与激素有关的所有原因导致的死亡率 本研究还审查了使用情况。 同样令人担忧的是， 排卵刺激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，回顾 对10 000名不孕妇女进行了队列研究。癌症风险 与医疗设备相关的应用也引起了人们的兴趣。 使用 宫内节育器，特别是惰性节育器， 子宫内膜癌的风险。 尽管隆胸手术已经被证明 干扰乳房病变的乳房X线摄影可视化， 一项病例对照研究发现，它们与降低乳腺癌风险有关， 与之前的几项前瞻性研究一致。 大 对13，000名接受美容植入的女性进行了回顾性队列研究， 目前正在进行中，以确定不同的植入物是否容易导致 各种形式的癌症以及结缔组织疾病; 关于癌症风险的兴趣在于硅胶植入物是否 易患多发性骨髓瘤，如最近NCI实验室所示 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.