閉経期ホルモンの使用と卵巣がんのリスク: 52件の疫学研究の個人参加者メタ解析
Lancet (London, England)
|February 17, 2015
まとめ
閉経期ホルモン療法の使用は,卵巣がんのリスクを高め,特に血清性および子宮内膜性タイプの卵巣がんのリスクを高めます. 停止した後でさえ,これらのタイプのリスクは,最大10年間上昇し続けます.
科学分野:
- 腫瘍学 腫瘍学
- エピデミオロジー エピデミオロジー
- 女性の健康 女性の健康
背景:
- 閉経期ホルモン療法 (MHT) に伴う卵巣がんのリスクは,未発表の研究と遡及研究における潜在的なバイアスのために不確実です.
- MHTと卵巣がんに関する以前の研究は限界があり,より堅実な評価が必要である.
研究 の 目的:
- バイアスを最小限に抑え,更年期ホルモン療法の卵巣がんリスクへの影響を正確に評価する.
- 総合的な評価のために,複数の疫学研究から得られた個々の参加者のデータを分析する.
主な方法:
- 52の疫学研究の個々の参加者データセットの集中分析.
- 主要な分析は,ホルモンセラピーのエキストラポレーションによる使用に関する前向きな研究に焦点を当てた.
- 敏感性分析には,相対リスク (RRs) を計算するために調整されたポアソン回帰を用いた遡及的研究が組み込まれました.
主要な成果:
- ホルモン療法の使用は,卵巣がんのリスクの増加と関連していました (RR 1.37).
- リスクは,5年未満の使用でも上昇し (RR 1.43) 現在のまたは最近のユーザーでは持続しました.
- 血清 (RR 1.53) と子宮内膜 (RR 1.42) 腫瘍のタイプではリスクが増加し,停止後10年までの残留リスクが観察されました.
結論:
- MHTに関連した卵巣がんのリスクの増加は,おそらく因果的である.
- 50歳頃に開始された5年間のMHTは,約1000人のユーザーに約1人の卵巣がんを増加させる可能性があります.
- これは,典型的な予後を想定して,約1700人のユーザーに1人の卵巣がんによる死亡が増加すると推定されています.
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