CASE CONTROL STUDY OF OVARIAN CANCER HORMONAL ETIOLOGY

1995年，在美国，大约有26,000个新的 卵巢癌病例，约有14，500名妇女死于卵巢癌， 使其成为最致命的妇科恶性肿瘤。 来 一生中，近2%的妇女受到影响。 卵巢癌是 难以治疗，因为它通常无症状，直到晚期 阶段，并且患者经常在疾病过程的后期出现。 的 已确定的风险因素并不能清楚地解释大部分的 疾病的发病率，以及可能的排卵或激素机制， 这些因素影响卵巢癌的风险并不好 明白 该应用程序提出了一种新的荷尔蒙假说， 卵巢癌的病因，并证明了大量的 病理学、内分泌学和流行病学证据支持这一点 假说. 一项以人群为基础的病例对照研究， 假设被提议在康涅狄格州进行。 的 一项研究将检查一系列与荷尔蒙表达有关的因素 在生育期间和之后。 总共约500个非粘液性 将确定80例年龄在35-79岁之间的粘液性卵巢癌病例 通过快速病例确认共享 耶鲁癌症中心的资源。 大约1,000名随机挑选的 人群对照将与三个年龄段的病例频率相匹配 组 将使用随机数字拨号来识别那些 年龄在65岁以下，从名册中随机挑选， 医疗保健融资管理为那些65岁以上。 所有 受试者将在家中接受训练有素的采访者的采访， 标准化、结构化的问卷，包括医疗和 生殖史，以及各种与生殖相关的近似值 因素 单变量和多变量分析将用于估计 病例与对照组比较的相对风险。 总的来说， 被检查的激素因素只受到很少的关注 关于卵巢癌，拟议的研究将是第一个 在一项严格的大规模研究中系统地评估它们， 将所有因素整合到一个连贯的病因学框架中。

DESCRIPTION: In the United States in 1995, there were about 26,000 new cases of cancer of the ovary, and approximately 14,500 women died from it, making it the most lethal of the gynecological malignancies. Over the lifetime, close to 2 percent of women are affected. Ovarian cancer is difficult to treat because it is typically asymptomatic until advanced stages, and patients frequently present late in the disease course. The established risk factors do not clearly account for a large fraction of disease incidence, and the possible ovulatory or hormonal mechanisms by which these factors affect risk of developing ovarian cancer are not well understood. The application suggests a new hormonal hypothesis regarding the aetiology of ovarian cancer, and demonstrates a substantial body of pathologic, endocrinologic and epidemiologic evidence in support of this hypothesis. A population-based, case-control study to examine this hypothesis is proposed to be conducted in the State of Connecticut. The study will examine a collection of factors related to hormonal expression during and after the reproductive years. In total, about 500 non-mucinous and 80 mucinous ovarian-cancer cases, aged 35-79 years, will be identified prospectively in the state through the Rapid Case Ascertainment Shared Resource of the Yale Cancer Center. Approximately 1,000 randomly-selected population controls will be frequency-matched to the cases in three age groups. Controls will be identified using random-digit dialing for those under 65 years of age, and randomly chosen from rosters, provided by the Health Care Financing Administration for those 65 years and over. All of the subjects will be interviewed at home by trained interviewers, using a standardized, structured questionnaire which will include medical and reproductive history, and approximations of the various hormone-related factors. Univariate and multivariate analyses will be used to estimate relative risks for comparison of the cases with the controls. In general, the hormonal factors to be examined have received only a little attention with respect to ovarian cancer, and the proposed study will be the first to evaluate them systematically in a rigorous, large-scale study which will integrate all of the factors within a coherent aetiologic framework.