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首页> 外文期刊>British Journal of Cancer >Hormone replacement treatment and breast cancer risk: a cooperative Italian study
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Hormone replacement treatment and breast cancer risk: a cooperative Italian study

机译：荷尔蒙替代治疗与乳腺癌风险：一项意大利合作研究

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The relationship between hormone replacement treatment (HRT) and breast cancer risk was analysed using data from a case-control study conducted between June 1991 and February 1994 in six Italian centres on 2569 patients aged below 75 with histologically confirmed breast cancer and 2588 controls admitted to hospital for a wide spectrum of acute, non-neoplastic, non hormone-related diseases. Ever HRT use was reported by 7.5% of cases and 7.5% of controls, corresponding to a multivariate odds ratio (OR) of 1.2 [95% confidence interval (CI), 0.9-1.5]. The risk increased with increasing duration of use: the ORs were 1.0 for use lasting less than 1 year, 1.3 for 1-4 years and 1.5 for 5 years or more. There was no clear pattern of risk with reference to time since starting use, but the OR was significantly elevated (OR = 2.0, 95% CI 1.3-2.9) for women who had stopped HRT within the last 10 years. No association was observed in those who had stopped HRT more than 10 years ago (OR = 1.0). The increased OR for women who had stopped HRT within the last 10 years was consistent across strata of identified covariates, and was significantly related to duration of use. This study confirms the absence of a strong association between HRT and breast cancer risk, although the risk estimate was above unity for women who had used HRT for 5 years or longer. However, the risk was significantly elevated in the short to medium term after use, particularly for long-term use. This short-term increased risk is consistent with an effect of HRT on one of the later stages of the process of breast carcinogenesis. The flattening of risk with increasing time since stopping, and hence the absence of a long-term cumulative excess in breast cancer risk after stopping HRT exposure, has relevant implications on individual risk assessment and public health.
机译：使用来自1991年6月至1994年2月在意大利的六个中心进行的病例对照研究的数据，分析了激素替代治疗（HRT）与乳腺癌风险之间的关系，该研究针对2569名年龄在75岁以下且经组织学确认为乳腺癌的患者和2588例接受对照的患者医院治疗各种急性，非肿瘤，非激素相关疾病。据报道，有7.5％的病例和7.5％的对照组曾使用过HRT，这对应于1.2的多元优势比（OR）[95％置信区间（CI），0.9-1.5]。风险随着使用时间的增加而增加：OR的使用期限少于1年为1.0，1-4年的使用为1.3，5年或更长时间的使用为1.5。自开始使用以来，尚无明确的时间风险模式，但在过去10年内停止HRT的女性OR显着升高（OR = 2.0，95％CI 1.3-2.9）。在超过10年前停止HRT的患者中未观察到关联（OR = 1.0）。在过去的10年中停止HRT的女性的OR升高在确定的协变量层次上是一致的，并且与使用时间长短显着相关。这项研究证实，尽管使用HRT 5年或更长时间的女性的风险估计高于统一性，但HRT与乳腺癌风险之间没有密切的关联。但是，使用后短期到中期的风险显着增加，特别是对于长期使用而言。这种短期增加的风险与HRT对乳腺癌致癌过程后期的作用一致。自停止治疗以来，风险随着时间的延长而趋于平缓，因此在停止接触HRT后没有长期的乳腺癌累积风险，这对个人风险评估和公共卫生具有重要意义。

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