协和医学杂志

2011, v.2(01) 7-14

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中国女性乳腺癌发病相关危险因素:病例对照研究
Risk Factors of Breast Cancer in China:A Case-Control Study

徐雅莉;孙强;单广良;张瑾;廖海波;李世拥;姜军;邵志敏;蒋宏传;沈念春;石岳;尉承泽;张保宁;陈妍华;段学宁;李波;
XU Ya-li1,SUN Qiang1,SHAN Guang-liang2,Zhang Jin3,Liao Hai-bo4,Li Shi-yong5,JIANG Jun6,Shao Zhi-min7,JIANG Hong-chuan8,SHEN Nian-chun9,SHI Yue10,YU Cheng-ze11,ZHANG Bao-ning12,CHEN Yan-hua13,DUAN Xue-ning14,LI Bo15 1Department of Breast Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China 2Epidemiology and Statistics,Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences & Peking Union Medical Colle

摘要(Abstract):

目的筛查中国女性乳腺癌发病相关危险因素,为个体化评估中国女性乳腺癌发病危险性提供依据。方法在全国8个省市14家研究中心开展1∶m配对病例对照研究,采用调查问卷通过面对面交流收集乳腺癌发病相关危险因素信息。乳腺癌患者及其配对健康对照女性年龄、生活环境相匹配。应用1∶m条件Logistic回归分析乳腺癌相关危险因素在病例组和对照组间的分布特点,明确其与乳腺癌发病危险性的相关性。结果共纳入416例乳腺癌患者及1156例健康对照女性。中国女性乳腺癌发病相关危险因素包括体重指数(body mass index,BMI)≥24(OR=4.07,95%CI:2.98~5.55),乳腺良性病变活检史(OR=1.68,95%CI:1.19~2.38),初潮年龄≥14岁(OR=1.41,95%CI:1.07~1.87),生存压力大(1~4级,OR=2.15,95%CI:1.26~3.66;5~9级,OR=3.48,95%CI:2.03~5.95),绝经(OR=2.22,95%CI:1.50~3.28)(P<0.05),乳腺癌家族史(OR=1.72,95%CI:1.15~2.58),肿瘤家族史(乳腺癌除外)(OR=1.55,95%CI:1.22~1.98)。口服避孕药(OR=1.59,95%CI:0.83~3.05)亦增加乳腺癌发病危险性,但差异未达到显著统计学意义(P>0.05)。结论中国女性乳腺癌发病相关危险因素包括BMI≥24、乳腺良性病变活检史、初潮年龄≥14岁、生存压力大、绝经、乳腺癌家族史及其他肿瘤家族史。本研究为个体化评估中国女性罹患乳腺癌危险性及广泛开展乳腺癌防治工作提供了依据。
Objective To screen the risk factors associated with breast cancer among Chinese women,with an attempt to provide evidence for the evaluation of breast cancer risks among Chinese women on an individual level.Methods A case-control study on 416 breast cancer patients and 1156 age-and region-matched controls was conducted in 14 hospitals in 8 provinces/municipalities of China.Conditional logistic regression was applied to analyze the association between risk factors and breast cancer.Results The risk factors of breast cancer among Chinese women included higher body mass index(BMI≥24)(OR=4.07,95%CI:2.98-5.55),history of benign breast disease biopsy(OR=1.68,95%CI:1.19-2.38),age of menarche≥14 years(OR=1.41,95%CI:1.07-1.87),psychological depression(for grade 1-4,OR=2.15,95% CI:1.26-3.66;for grade 5-9,OR=3.48,95% CI:2.03-5.95),menostasia(OR=2.22,95% CI:1.50-3.28),family history of breast cancer(OR=1.72,95%CI:1.15-2.58),and family history of cancer other than breast cancer(OR=1.55,95%CI:1.22~1.98)(all P<0.05 when compared between the 416 breast cancer patients and 1156 controls).Although use of oral contraceptives(OC)(OR=1.59,95% CI:0.83-3.05)was associated with an increased risk of breast cancer,the difference was not statistically significant(P>0.05).Conclusions Many risk factors including BMI≥24,history of benign breast disease biopsy,age of menarche≥14 years,psychological depression,menostasia,family history of breast cancer,and family history of cancer other than breast cancer may contribute to breast cancer among Chinese women.This research provides a basis for the individualized evaluation of risks of breast cancer and the population-based interventions in China.

关键词(KeyWords): 乳腺癌;危险因素;病例对照研究
breast cancer;risk factors;case-control study

Abstract:

Keywords:

基金项目(Foundation): “十一五”国家科技支撑计划项目(2006BAI02A09)

作者(Author): 徐雅莉;孙强;单广良;张瑾;廖海波;李世拥;姜军;邵志敏;蒋宏传;沈念春;石岳;尉承泽;张保宁;陈妍华;段学宁;李波;
XU Ya-li1,SUN Qiang1,SHAN Guang-liang2,Zhang Jin3,Liao Hai-bo4,Li Shi-yong5,JIANG Jun6,Shao Zhi-min7,JIANG Hong-chuan8,SHEN Nian-chun9,SHI Yue10,YU Cheng-ze11,ZHANG Bao-ning12,CHEN Yan-hua13,DUAN Xue-ning14,LI Bo15 1Department of Breast Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China 2Epidemiology and Statistics,Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences & Peking Union Medical Colle

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