更年期激素使用和卵巢癌风险:对52项流行病学研究的个人参与者分析
Lancet (London, England)
|February 17, 2015
概括
绝经期使用激素治疗会增加卵巢癌的风险,特别是在血清和子宫内膜类型. 即使在停止使用后,这些类型的风险在长达十年内仍然很高.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 妇女健康 妇女健康
背景情况:
- 与更年期激素疗法 (MHT) 相关的卵巢癌风险是不确定的,原因是未发表的研究和回顾性研究中的潜在偏见.
- 之前对MHT和卵巢癌的研究存在局限性,需要进行更严格的评估.
研究的目的:
- 尽量减少偏见并准确评估更年期激素治疗对卵巢癌风险的影响.
- 分析来自多项流行病学研究的个体参与者数据,以进行全面的评估.
主要方法:
- 来自52项流行病学研究的个人参与者数据集的集中分析.
- 主要分析的重点是前性研究,其中使用了额外推算的激素治疗.
- 敏感性分析包含了回顾性研究,使用调整后的波松回归来计算相对风险 (RRs).
主要成果:
- 激素治疗使用与卵巢癌的风险增加有关 (RR 1.37).
- 即使使用时间不到5年 (RR 1.43) 风险也会增加,并且在当前或最近的用户中持续存在.
- 血清 (RR 1.53) 和子宫内膜 (RR 1.42) 瘤类型的风险增加,停药后长达10年的残留风险.
结论:
- 观察到与MHT相关的卵巢癌风险增加可能是因果关系的.
- 在50岁左右开始的五年MHT可能会导致每1000名用户大约增加一个卵巢癌.
- 这意味着估计每1700名使用者增加1例卵巢癌死亡,假设典型的预后.
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