乳腺癌和卵巢癌相关病因：生殖因素，口服避孕
Attributable Causes of Breast Cancer and Ovarian Cancer in China: Reproductive Factors, Oral Contraceptives and Hormone Replacement Therapy
乳腺癌和卵巢癌相关病因：生殖因素，口服避孕药和激素替代疗法
Abstract:Objective:To provide an evidencebased,consistent assessment of the burden of breast cancer attributable to reproductive factors （RFs,including nulliparity,mean number of children,age at first birth and breastfeeding），use of oral contraceptives （OCs,restricted to the age group of 15-49 years），and hormone replacement therapy （HRT），as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005.
Methods:We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China.In the case of RFs,we compared the exposure distributions in 2001 and counterfactual exposure.Results:Exposure of RFs in 2001 was found to account for 6.74％ of breast cancer,corresponding to 9,617 cases and 2,769 deaths,and for 2.78％ of ovarian cancer （711 cases,294 deaths）。The decrease in mean number of children alone was responsible for 1.47％ of breast cancer and 2.78％ of ovarian cancer.The prevalence of OC use was 1.74％ and the population attributable fraction （PAF） of breast cancer was 0.71％，corresponding to 310 cases and 90 deaths.The PAF of breast cancer due to HRT was 0.31％，resulting in 297 cases and 85 deaths.Conclusion:RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality,whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.
摘要：目的：基本依据，乳房癌变与生殖因素（RFs,包括未孕，孩子量，首个孩子年龄和哺乳），口服避孕药（OCs,15-49岁之间）及激素替代疗法（HRT）有关，同样卵巢癌与2005年生育孩子量有关。
方法：从科研及大型的学术统计我们推断乳腺癌及卵巢癌发病率的危险因素及相关因素。生殖因素情况下，我们对比了2001年数据及参照数据。结果：2001年，生殖因素情况下，我们发现乳腺癌死亡率是6.74%,对应的9,617 例死亡2,769例。卵巢癌2.78%死亡率（711例，死亡294例）。乳腺癌死亡率降低到1.47％及卵巢癌2.78% ，主要与生育的孩子数量有关。口服避孕药患病率是1.74%及人群是 0.71％，相当于310例90例死亡 。 激素替代疗法（HRT）人群是 0.31％，297例85例死亡。结论：生育因素很大程度降低了乳房癌和卵巢癌发病率和死亡率，同样 激素替代疗法（HRT） 及口服避孕药降低了乳房癌 的发病率
