更年期激素替代疗法和卵巢癌的风险
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
概括
长期仅使用雌激素的激素替代疗法显著增加了卵巢癌的风险. 雌激素-孕激素治疗没有显示短期使用的风险增加,但长期影响需要进一步研究.
科学领域:
- 妇科 妇科医生 妇科
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 更年期激素替代疗法 (HRT) 与卵巢癌风险之间的关系尚不清楚.
- 这项研究调查了不同类型的HRT与卵巢癌发病率之间的关联.
研究的目的:
- 为了确定仅用雌激素,仅用雌激素和前列腺激素或组合HRT是否会增加卵巢癌的风险.
- 评估HRT使用时间对卵巢癌风险的影响.
主要方法:
- 这是一项从1979年到1998年对44241名绝经后妇女的队列研究.
- 数据来自美国29个临床中心的乳腺癌检测示范项目的前参与者.
- 发生的卵巢癌是主要的结果指标,时间依赖的分析根据相关风险因素进行了调整.
主要成果:
- 曾经仅使用雌激素的HRT与卵巢癌风险增加有显著的关联 (RR, 1.6).
- 仅使用雌激素的持续时间增加显示出与卵巢癌风险 (20+年:RR,3.2) 有显著的剂量反应关系.
- 仅使用雌激素和孕激素的HRT并没有显著增加卵巢癌风险,即使使用时间较长.
结论:
- 长期使用仅含雌激素的HRT (≥10年) 与卵巢癌的风险显著增加有关.
- 短时间使用雌激素-孕激素单独的HRT与风险增加无关.
- 需要进一步的研究来澄清与短期和长期雌激素-孕激素替代疗法相关的风险.
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