Breast Cancer Incidence and Hormone Replacement Therapy in Canada

被引:50
作者
De, Prithwish [1 ]
Neutel, C. Ineke [2 ]
Olivotto, Ivo [3 ]
Morrison, Howard [4 ]
机构
[1] Canadian Canc Soc, Toronto, ON M4V 3B1, Canada
[2] Univ Ottawa, Dept Epidemiol & Community Med, Ottawa, ON, Canada
[3] British Columbia Canc Agcy, Breast Canc Outcomes Unit, Vancouver, BC V5Z 4E6, Canada
[4] Publ Hlth Agcy Canada, Ctr Chron Dis Prevent & Control, Ottawa, ON, Canada
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2010年 / 102卷 / 19期
关键词
ESTROGEN PLUS PROGESTIN; SCREENING MAMMOGRAPHY; INCIDENCE RATES; CLINICAL-TRIAL; DECREASE; DECLINES; RISK; AGE;
D O I
10.1093/jnci/djq345
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background In 2002, results of the Women's Health Initiative clinical trial indicated that the long-term risks of combined estrogen and progestin hormone replacement therapy outweighed the health benefits for postmenopausal women. The resulting decline in use of hormone replacement therapy was followed by concurrent decreases in breast cancer incidence in several countries. The aim of the current study was to determine whether similar declines occurred in Canada. Methods Data on prescriptions for hormone therapy were obtained from a national registry of pharmacy-filled prescriptions to confirm the reported trend in use of hormone replacement therapy among approximately 1200 women aged 50-69 years who participated in the National Population Health Survey between 1996 and 2006 and whose data were extrapolated to the Canadian female population. Age-standardized incidence rates for breast cancer were obtained from the population-based Canadian Cancer Registry for the same period, and mammography rates were obtained from the Canadian Community Health Survey. Joinpoint regression was used to examine changes in trends in the use of hormone replacement therapy and breast cancer incidence. Results A reduced frequency of use of hormone replacement therapy was reflected in the decrease in dispensed hormone therapy prescriptions after 2002. The largest drop in use of combined hormone replacement therapy (from 12.7%, 95% confidence interval [CI] = 10.1% to 14.2%, to 4.9%, 95% CI = 3.4% to 6.8%, of all women) occurred between January 1, 2002, and December 31, 2004, among women aged 50-69 years. This drop occurred concurrently with a 9.6% decline in the incidence rate of breast cancer (from 296.3 per 100 000 women, 95% CI = 290.8 to 300.5 per 100 000 women, in 2002 to 268.0 per 100 000 women, 95% CI = 263.3 to 273.5 per 100 000 women, in 2004). Mammography rates were stable at 72% over the same period. Conclusion During the period 2002-2004, there was a link between the declines in the use of hormone replacement therapy and breast cancer incidence among Canadian women aged 50-69 years, in the absence of any change in mammography rates.
引用
收藏
页码:1489 / 1495
页数:7
相关论文
共 35 条
[31]  
TAMBAY JL, 1995, HLTH REP, V7, P31
[32]   Hormone replacement therapy, mammography screening and changing age-specific incidence rates of breast cancer: an ecological study comparing two European populations [J].
Verkooijen, H. M. ;
Koot, V. C. M. ;
Fioretta, G. ;
van der Heiden, M. ;
Schipper, M. E. I. ;
Rapiti, E. ;
Peeters, P. H. M. ;
Peterse, J. L. ;
Bouchardy, C. .
BREAST CANCER RESEARCH AND TREATMENT, 2008, 107 (03) :389-395
[33]  
WYNDER EL, 1978, CANCER-AM CANCER SOC, V41, P2341, DOI 10.1002/1097-0142(197806)41:6<2341::AID-CNCR2820410637>3.0.CO
[34]  
2-N
[35]  
Zahl PH, 2007, NEW ENGL J MED, V357, P510