ホルモン療法と卵巣がん
Lina Steinrud Mørch1, Ellen Løkkegaard, Anne Helms Andreasen
1Gynaecological Clinic, Rigshospitalet, Copenhagen University, 2100 Copenhagen, Denmark. linamorch@yahoo.dk
JAMA
|July 16, 2009
まとめ
閉経後のホルモン療法は,製剤や期間に関係なく,卵巣がんのリスクを増やす. リスクは中断後に低下し,年間8300人の女性あたり約1人の追加症例の絶対的な増加があります.
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:
- 閉経後のホルモン療法 (HT) の使用は,卵巣がんのリスクの増加と関連しています.
- 異なるHT製剤,レジメン,投与経路がこのリスクにどのように影響するかに関するデータは限られている.
研究 の 目的:
- 閉経前および閉経後の女性の様々なホルモン療法と卵巣がんのリスクとの関連性を評価する.
主な方法:
- デンマーク (1995-2005) で実施された全国的な前向きコホート研究には,50歳から79歳までの女性100万人近くが参加した.
- 個別レベルの処方データと国家がん登録簿は,HT使用と卵巣がんの発生率を追跡するために使用されました.
- プーソン回帰分析は,時間依存の共変数としてホルモン被曝を評価した.
主要な成果:
- 現在のHT使用者は,すべての卵巣がんの38%の増加リスク (IRR1.38) と,非使用者と比較して,上皮卵巣がんの44%の増加リスク (IRR1.44) を示しました.
- 卵巣がんのリスクは,最後のHT使用以来の時間とともに減少し,2~4年後には無意味になります.
- HTの配方,持続時間,またはプロゲスティンのタイプに基づいてリスクの有意な差異は観察されなかった.
結論:
- ホルモン療法は,卵巣がんのリスクの増加と関連しています.
- この増加したリスクは,異なるHT製剤,投与量,投与レジメン,投与経路において一貫しています.
- この発見は,ホルモン療法を用いる女性の卵巣がんリスクを考慮することの重要性を強調しています.
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