BMJ：激素替代治疗类型及持续时间相关的乳腺癌风险

2020-10-31 MedSci原创 MedSci原创

不同激素替代治疗人群的乳腺癌风险不一致，近5年内长期应用雌激素治疗或雌激素-孕激素联合治疗人群需警惕乳腺癌风险

激素替代治疗(Hormonereplacementtherapy，HRT)是指对存在雌激素缺乏的绝经后妇女补充雌激素及孕激素以缓解其更年期症状的治疗。2017年10月27日，世界卫生组织国际癌症研究机构公布的致癌物清单初步整理参考中，雌激素-孕激素更年期治疗(合用)在一类致癌物清单。近日研究人员评估与不同类型和激素代替疗法的持续时间(HRT)相关的乳腺癌风险。

研究人员考察了英国Q Research数据库中相关资料，在1998年至2018年间，包含有98611名50-79岁的妇女乳腺癌患者数据，按年龄、一般做法和索引日期，与457498名女性对照组相匹配。研究的主要终点为HRT类型及持续时间相关的乳腺癌风险，根据个人特征、吸烟状况、饮酒、共患病、家族史和其他处方药物进行调整。

总体而言，33703名（34%)乳腺癌患者和134391名(31%）对照组在索引日期前一年接受了HRT治疗。与从未使用HRT的人群相比，近5年内，长期使用HRT（≥5年）的人群，仅雌激素治疗或雌激素-孕激素联合治疗都与乳腺癌的风险增加有关（调整后的优势比为1.15和1.79）。在联合孕激素治疗的人群中，炔诺酮导致的乳腺癌风险最高（1.88），而去氢孕酮风险最低（1.24）。过去长期仅使用雌激素治疗和过去短期（<5年）使用雌激素-孕激素治疗人群的乳腺癌风险未见显著增加，但过去长期使用雌激素-孕激素联合治疗人群的相关乳腺癌风险仍然增加（1.16）。在最近仅使用雌激素的人群中，每10000名参与者随访年有3例（年轻女性）至8例(老年女性）额外病例，在雌激素-孕激素联合使用者中预计每10000名参与者随访年有9-36例额外病例。对于过去使用雌激素-孕激素治疗人群中，每10000名参与者随访年会有2至8例额外病例。

研究认为，不同激素替代治疗人群的乳腺癌风险不一致，近5年内长期应用雌激素治疗或雌激素-孕激素联合治疗人群需警惕乳腺癌风险。

原始出处：

Yana Vinogradova et al. Use of hormone replacement therapy and risk of breast cancer： nested case-control studies using the QResearch and CPRD databases.BMJ. 28 October，2020.

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2020-12-17 gaoxiaoe

#BMJ#

62 0
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2021-03-23 病毒猎手

#激素替代治疗#

143 0
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2020-11-07 docwu2019

#癌风险#

0 0
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2021-09-19 wfang555

#替代治疗#

57 0
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2020-11-04 gaoxiaoe

#乳腺癌风险#

61 0
[GetPortalCommentsPageByObjectIdResponse(id=1849124, encodeId=44f21849124b0, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Dec 17 01:11:01 CST 2020, time=2020-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950544, encodeId=7e3c9505443c, content=<a href='/topic/show?id=4a9e66832e7' target=_blank style='color:#2F92EE;'>#激素替代治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66832, encryptionId=4a9e66832e7, topicName=激素替代治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 23:14:06 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2061969, encodeId=8327206196922, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Sat Nov 07 18:11:01 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692872, encodeId=131316928e26c, content=<a href='/topic/show?id=e6d86032ee8' target=_blank style='color:#2F92EE;'>#替代治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60327, encryptionId=e6d86032ee8, topicName=替代治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b79d29305168, createdName=wfang555, createdTime=Sun Sep 19 09:11:01 CST 2021, time=2021-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1770329, encodeId=a8ad1e70329de, content=<a href='/topic/show?id=df9c23e868a' target=_blank style='color:#2F92EE;'>#乳腺癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23786, encryptionId=df9c23e868a, topicName=乳腺癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9538161180, createdName=gaoxiaoe, createdTime=Wed Nov 04 18:11:01 CST 2020, time=2020-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503676, encodeId=f9d215036e651, content=<a href='/topic/show?id=4f215634296' target=_blank style='color:#2F92EE;'>#持续时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56342, encryptionId=4f215634296, topicName=持续时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13e29684821, createdName=zhwj, createdTime=Sun Nov 01 23:11:01 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895868, encodeId=633c895868de, content=不同<a href='/topic/show?id=6fde98e68c3' target=_blank style='color:#2F92EE;'>#雌激素替代治疗#</a>人群的<a href='/topic/show?id=73c423e2572' target=_blank style='color:#2F92EE;'>#乳腺癌#</a>风险不一致，近5年内长期应用<a href='/topic/show?id=c55098e5612' target=_blank style='color:#2F92EE;'>#雌激素#</a>治疗或雌激素-孕激素联合治疗人群需警惕乳腺癌风险。因此，不要轻易使用雌激素替代治疗, beContent=null, objectType=article, channel=null, level=null, likeNumber=227, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98768, encryptionId=6fde98e68c3, topicName=雌激素替代治疗), TopicDto(id=23725, encryptionId=73c423e2572, topicName=乳腺癌), TopicDto(id=98756, encryptionId=c55098e5612, topicName=雌激素)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Oct 31 15:01:53 CST 2020, time=2020-10-31, status=1, ipAttribution=)]
2020-11-01 zhwj

#持续时间#

64 0
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2020-10-31 lovetcm

不同#雌激素替代治疗#人群的#乳腺癌#风险不一致，近5年内长期应用#雌激素#治疗或雌激素-孕激素联合治疗人群需警惕乳腺癌风险。因此，不要轻易使用雌激素替代治疗

227 0

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