女性乳腺癌危险因素的Meta分析

Meta-analysis of study on risk factors of female breast cancer

目的运用Meta分析方法综合分析评价国内外女性乳腺癌的危险因素。方法收集1997-2007年国内外有关乳腺癌危险因素的研究文献,采用Meta分析的随机效应模型,计算有关危险因素的比值比(odds ratio,OR)及95%可信区间(confidence interval,CI)。结果共筛选出相关文献31篇,其中,国内15篇,国外16篇。良性乳腺病史(AORs=1.95,95% CI:1.59～2.38)、乳腺癌家族史(AORs=1.58,95% CI:1.35～1.85)、绝经年龄>50岁(ORs=1.39,95% CI:1.22～1.57)和口服避孕药(AORs=2.12,95% CI:1.24～3.62)为乳腺癌的危险因素;足月妊娠数≥1胎(AORs=0.63,95% CI:0.60～0.68)和母乳喂养(ORs=0.76,95% CI:0.64～0.90)为乳腺癌的保护因素。结论控制人群乳腺癌的发生,应从降低良性乳腺疾病、提倡母乳喂养和注意高危人群筛检等方面采取有效措施。

Objective To explore the risk factors of breast cancer in or outside China by Meta analysis. Methods We searched all English-language and Chinese-language papers published from January 1st, 1997 to December 31st, 2007. Taking into account the possibility of heterogeneity test, random effect meta-analysis model was adopted to calculate the combined odds ratio （OR）. Results 31 papers were identified among which 15 Chinese papers published in China and 16 English papers published outside China. A total of 31 studies calculated pool ORs indicated that personal history of benign breast disease （Adjusted ORs=1.95,95% CI：1.59～2.38）, family history of breast cancer in first-degree relative （Adjusted ORs=1.58, 95% CI：1.35～1.85）, postmenopausal 〉50 years （ORs=1.39,95% CI：1.22～1.57） and oral contraceptive use （Adjusted ORs=2.12,95% CI：1.24～3.62） were associated with increase in breast cancer risk while the summary OR based on number of full-term pregnancy ≥1 （Adjusted ORs=0.63,95% CI：0.60～0.68） and breastfed （ORs=0.76,95% CI：0.64～0.90） indicated no association with breast cancer risk. Conclusions Decreasing benign breast disease, advocating breastfed and examining high risk population will be the effective measures to control breast cancer in women.