月经生育因素与女性乳腺癌关系的病例对照研究  

REPRODUCTIVE FACTORS AND BREAST CANCER IN A POPULATION BASED CASE CONTROL STUDY

作　　者：李泓澜[1] 高立峰[1] 杨工[1] 项永兵[1] 金凡[1] 

机构地区：[1]上海市肿瘤研究所流行病研究室,上海200032

出　　处：《肿瘤》2000年第2期88-92,共5页Tumor

基　　金：国家"九五"科技攻关项目资助

摘　　要：目的　探讨生育因素与女性乳腺癌的联系性 ,并结合 10年前的研究 ,比较生育因素在上海市区妇女中的时间趋势变化 ,以期从一个侧面对逐年增高的女性乳腺癌发病情况作出可能的解释。方法　一项基于全人群的病例对照研究 ,收集到 44 8对 ,1∶ 1年龄配对。通过条件 L ogistic模型进行相对危险度及剂量 -反应效应估计。结果　在调整一些可能的混杂因素后 ,月经初潮年龄≤ 12岁者发生乳腺癌的危险较 >12岁者高 4倍 ,95 %CI=1.7～ 14.5。行经年数长(≥ 40年 )与较短组 (<30年 )比较 ,有增加患乳腺癌危险的趋势 ,但该联系未达到显著性水平 (OR=1.8,95 %CI=0 .8～ 4.1)。高产次妇女 (≥ 3次 )的乳腺癌危险较未经产妇降低 6 0 %,趋势检验 P<0 .0 1。未发现流产与女性乳腺癌相关联。进一步调整产次后 ,累积哺乳月数与乳腺癌危险呈显著负相关 ,累积哺乳时间超过一年的与未哺乳者比较 OR=0 .5 ,95 %CI=0 .3～ 0 .8。口服避孕药与乳腺癌的相关不密切。结论　生育因素是一类影响女性乳腺癌的主要因素。与以往研究结果比较 ,该人群中的初潮年龄有提早趋势 ,而生产次数、累积哺乳时间则显著减少 。Objective To study the association between reproductive factors and breast cancer, and to compare the current status of menstruation and reproduction in Shanghai women with that in the middle of 1980s, and try to partly explain the yearly increasing incidence of breast cancer.Methods A population based case control study was conducted by recruited 448 cancer cases and matched by 448 controls. Logistic model was applied to estimate the association between risk factors and the cancer. Results After adjustment for some potential confounding factors, the women whose age of menarche was at 12 or earlier had four fold increased risk (95% CI=1 7～14 5) compared with those who had menses after 12. The long period of menstruation (≥40 years) tended to be associated with an increased risk relative to <30 years, although the association was not statistically significant (OR=1.8, 95% CI=0 8～4 1). Parous women, who had delivered ≥3 times including premature delivery, had significantly decreased risk by 60% relative to nulliparous women, being with a significant dose response relationship ( P <0 01). No significant association was found with the women undergone artificial abortion or had accidental abortion. After further adjusted for the number of delivery, the risk of breast cancer was significantly decreased with increasing in the cumulative months of lactation. The OR for the women who had lactated for >12 months was 0.5 (95% CI=0.3～0 8) compared with those never done. A positive relationship was not found between administering oral contraceptives and the risk. Conclusion The reproductive factors play independently an important role in developing breast cancer. Compared with the results from some studies conducted more than 10 years ago, women in Shanghai recently tend to be at earlier age of menarche, have fewer times of delivery and less cumulative time of lactation. These changes of characteristics of menstruation and reproduction may partly explain the temporal trend of increasing incidence of

关 键 词：乳腺癌 月经 生育 病例对照研究 

分 类 号：R737.9[医药卫生—肿瘤]