更年期ホルモン補充療法と卵巣がんのリスク
James V Lacey1, Pamela J Mink, Jay H Lubin
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd, MSC 7234, Rockville, MD 20852, USA. jimlacey@nih.gov
JAMA
|July 16, 2002
まとめ
長期にわたるエストロゲン単独ホルモン代用療法では,卵巣がんのリスクが著しく増加します. エストロゲン・プロゲステン療法では,短期的な使用でリスクが増加することはなかったが,長期的な効果についてはさらなる研究が必要である.
科学分野:
- 婦人科 婦人科について
- 腫瘍学 腫瘍学
- エピデミオロジー エピデミオロジー
背景:
- 更年期ホルモン置換療法 (HRT) と卵巣がんのリスクとの関係は不明である.
- 本研究では,さまざまなタイプのHRTと卵巣がんの発生率との関連を調査しています.
研究 の 目的:
- エストロゲン単独,エストロゲン対プロゲステン単独,または併用HRTが卵巣がんリスクを増加させるかどうかを判断する.
- 卵巣がんリスクに対するHRT使用期間の影響を評価する.
主な方法:
- 1979年から1998年までの44241人の閉経後の女性を対象としたコホート研究.
- 29の米国臨床センターの乳がん検知実証プロジェクトの元参加者から収集されたデータです.
- 卵巣がんの発生が主なアウトカム指標であり,時間依存の分析は関連する危険因子に調整された.
主要な成果:
- エストロゲンのみのHRTの使用は,卵巣がんのリスクの増加と有意に関連していました (RR, 1.6).
- エストロゲン単独使用の持続時間増加は,卵巣がんリスク (20年以上:RR, 3.2) との有意な用量反応関係を示した.
- エストロゲン・プロゲステンのみのHRTは,使用期間が長くても,卵巣がんのリスクが有意に増加することはありませんでした.
結論:
- エストロゲンのみのHRTの長期使用 (≥10年) は,卵巣がんのリスクが著しく上昇しているとの関連があります.
- エストロゲンとプロゲステンのみのHRTの短期間の使用は,リスクの増加と関連しませんでした.
- 短期および長期のエストロゲン・プロゲステン置換療法に関連するリスクを明らかにするために,さらなる研究が必要である.
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