在levonorgestrel释放子宫内系统暴露时间和乳腺癌发病率之间存在关联
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Jin-Sung Yuk1, Myoung Hwan Kim, Sang Hee Yoon
1Department of Obstetrics and Gynecology, Sanggye Paik Hospital, Inje University College of Medicine.
Obstetrics and gynecology
|March 13, 2025
概括
levonorgestrel释放子宫内系统 (LNG-IUS) 可能会增加乳腺癌的风险,特别是在使用的头几年. 这一发现对于使用LNG-IUS治疗妇科病症的女性至关重要.
科学领域:
- 生殖健康 生殖健康
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- levonorgestrel释放子宫内系统 (LNG-IUS) 被广泛用于避孕和治疗妇科疾病,如子宫内膜异位症和异常子宫出血.
- 了解LNG-IUS的长期安全性,特别是其与乳腺癌风险的关联,对于明智的临床决策至关重要.
研究的目的:
- 调查使用levonorgestrel释放子宫内系统 (LNG-IUS) 持续时间和患乳腺癌的风险之间的关联.
- 分析不同持续时间的LNG-IUS使用对韩国女性乳腺癌发病率的影响.
主要方法:
- 一项回顾性队列研究利用了韩国国家医疗保险索赔数据库 (2013-2022).
- 包括2,094,029名30-49岁的女性,他们被诊断患有子宫内膜异位症,子宫瘤或异常子宫出血.
- 倾向性得分匹配和Cox比例危险模型被用来评估LNG-IUS暴露时间和乳腺癌风险之间的关系.
主要成果:
- 该研究包括61010名女性,LNG-IUS组的乳腺癌发病率为每10万人年223人,而非LNG-IUS组的154人.
- 整体LNG-IUS使用与乳腺癌风险增加有关 (HR 1.38).
- 早期使用 (不到3年) 显示风险明显增加 (HR 5.40),风险降低,但随着更长的持续时间 (3-4.9年:HR 3.44;5年以上:HR 1.77) 风险仍然增加.
结论:
- 使用LNG-IUS可能与患有异常子宫出血,子宫内膜异位症或乳腺瘤的妇女患乳腺癌的风险增加有关.
- 在LNG-IUS使用的最初几年中,这种风险似乎特别明显.
- 进一步的研究是有必要的,以阐明机制,并确认这些发现在不同的人口.
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