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青山妩媚

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口服避孕藥降低卵巢癌風險  

2008-07-13 16:44:41|  分类: 營養健康 |  标签: |举报 |字号 订阅

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口服避孕藥降低卵巢癌風險 - 青山妩媚 - 青山妩媚

避孕药与卵巢癌:持久的保护(丁香園戰友譯文:http://www.dxy.cn/bbs/post/view?bid=116&id=11059866&sty=1&tpg=3&age=0
重新分析了45项研究证实口服避孕药在使用了数十年后女性最需要它的时候能够提供保护。
近期,研究者重新分析了45项集中在欧洲和美国的对照、前瞻性研究总体上有31%的病例组和37%的对照组使用避孕药,平均使用期限分别是4.4年和5.0年。总体上,曾经使用过OC和没有使用过OC组的患有卵巢癌的相对风险是0.73。
长期使用OC与卵巢癌的低风险是相关的。 尽管时间越久,保护作用会减少,OC停用后的30年,其减少的风险仍然有效的。
评论:这项大型的重分析的结果显示,使用OC的女性数十年后的卵巢癌的风险降低,尽管发生率很低,但是致死性疾病减少。作者估计大概是自从50年前避孕药开始出现时起,全世界内有约200000例卵巢癌的发生和约100000例的卵巢癌的死亡病例得到避免。作者还预计将来由于避孕药的使用,每年能够预防超过3万例的卵巢癌的发生。由于在高危和低危的女性中OC都可以预防卵巢的恶性发展,这些结果尤其是与患卵巢癌的危险性增加的女性相关,包括低生育力的女性,家族史异常,以及有致病性的BRCA基因突变。

 

The Pill and Ovarian Cancer: Persistent Protection
Reanalysis of 45 studies verified that oral contraceptives provide protection when women need it most: decades after use.

Although oral contraceptives (OCs) have been shown to reduce the risk for epithelial ovarian cancer, the duration of this protective effect has not been clearly defined. Now, investigators have reanalyzed data from 45 case-control and prospective studies (primarily in Europe and the U.S.) including more than 23,000 women with ovarian cancer (cases; mean age at diagnosis, 56) and 87,000 women without the disease (controls). Overall, 31% of the cases and 37% of the controls had used the pill; average duration of OC use was 4.4 and 5.0 years, respectively.

Overall, the relative risk for ovarian cancer in OC ever-users versus never-users was 0.73 (95% confidence interval, 0.70–0.76; P<0.0001). Table 1 shows the estimated absolute risk for ovarian cancer before age 75 in never-users and ever-users.

Longer duration of OC use was associated with lower risk for ovarian cancer: For example, relative risk was approximately halved in women who had used OCs for 15 years. Although protection attenuated with time, reduced risk still existed more than 30 years after OC use was stopped. Adjustment for several potentially confounding factors (e.g., ethnic group, use of hormone therapy, BMI) had little effect on these observations. In analyses based on calendar year of OC use as a proxy for estrogen dose, the findings were similar regardless of OC formulation.

Comment: The results of this massive reanalysis show that women who use OCs have a reduced risk for ovarian cancer decades later, when the incidence of this uncommon but lethal disease peaks. The authors estimate that since the pill first became available almost 50 years ago, some 200,000 incident cases and 100,000 deaths from ovarian cancer have been prevented worldwide. The authors go on to speculate that in the future, use of the pill will prevent more than 30,000 ovarian cancers annually. Because OCs can prevent ovarian malignancy in both high- and low-risk women, these findings are especially relevant to women at elevated risk for ovarian cancer — including low-parity women and those who have a positive family history or who carry a deleterious BRCA mutation.

— Andrew M. Kaunitz, MD

Published in Journal Watch Women's Health January 31, 2008

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