在子宫内暴露于二甲基stilbestrol后的癌症风险
Naomi B Boekel1, Janneke Verloop2, Hester H van Boven3
1Department of Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.
European journal of epidemiology
|May 27, 2025
概括
在子宫内接触过二甲基stilbestrol (DES) 的女性,甚至在较年长的年龄组中,阴道癌的风险明显增加,包括清细胞腺癌 (CCAC) 和状细胞癌 (SCC). 然而,他们的整体癌症和乳腺癌风险与未暴露的个体相似.
科学领域:
- 妇科瘤学 妇科瘤学
- 癌症流行病学 癌症流行病学
- 生殖健康 生殖健康
背景情况:
- 在子宫内暴露于乙醇 (DES) 是阴道和子宫清细胞腺癌 (CCAC) 的已知危险因素.
- 长期的癌症风险,特别是在老年人群中,以及乳腺癌等生殖道以外的癌症,对于暴露于DES的女性来说,仍然不完全理解.
研究的目的:
- 为了评估长期的癌症发病率,包括乳腺癌,在妇女暴露在子宫内DES.
- 为了确定阴道和宫癌的风险增加是否持续到老年人群.
- 在暴露于DES的女性中评估特定阴道癌亚型 (CCAC和SCC) 的风险.
主要方法:
- 一项全国性的队列研究,涉及12,249名暴露于DES的妇女和2,070名未暴露的姐妹.
- 数据收集包括有关激素风险因素和病史的问卷.
- 癌症发病率通过与全国癌症登记册的联系来确定.
主要成果:
- 与一般人群相比,暴露于DES的女性在总体癌症风险 (SIR=0.98) 或乳腺癌风险 (SIR=1.03) 中没有显著差异.
- 观察到阴道癌症的风险显著增加 (SIR=10.5),在所有年龄段持续存在,包括60-69岁.
- 阴道的透明细胞腺癌 (CCAC; SIR=49.1) 和状细胞癌 (SCC; SIR=5.86) 在暴露于DES的女性中显著增加.
结论:
- 除了已确定的阴道癌 (CCAC和SCC) 风险增加之外,在子宫内暴露于DES的女性似乎没有增加其他癌症,包括乳腺癌的风险.
- 在老年人群中阴道癌的风险仍然很高,这表明需要扩大查建议.
- 在暴露于子宫内DES的女性中,应考虑对阴道癌进行查,直到超过当前建议的年龄 (<60岁).
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