胎次与乳腺癌风险之间的关系:对证据的批判性审查(重点是撒哈拉以南非洲)

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
S. Azubuike
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引用次数: 0

摘要

胎次与乳腺癌之间的关系在高收入国家得到了广泛的调查。然而,在撒哈拉以南非洲(SSA)地区,只有少数研究调查了这种关联。本研究的目的是批判性地回顾现有证据,突出其优势和不足,从而为更多关于该主题的SSA研究提供基础。在MEDLINE、Scopus、PubMed、谷歌Scholar中检索文献,并检索已发表研究的参考文献。根据样本量、地理分布和研究结果的相关性,选择2000年至2018年间发表的关键病例对照和队列研究进行详细审查。非分析性研究被排除在外。使用基于R统计软件3.4.0(2017)版本的表格和森林图对研究结果进行总结。这主要是为了提供所审查研究的直观概述,而不一定是为了提供汇总估计。通过比较各国和SSA中观察到的显著发现的数量(根据置信区间评估)与不显著发现的数量,并考虑到它们的优缺点,得出了结论。我们回顾了北美、欧洲、亚洲和非洲四个地区的26项病例对照研究和12项队列研究。大多数研究,特别是来自高收入国家的研究,都观察到乳腺癌(特别是雌激素受体[ER]阳性乳腺癌)的风险降低。虽然有几项研究报告了SSA的不显著观察结果,但样本量有限,少数观察到所有妇女的乳房产次风险降低的研究受到混淆。然而,最近的研究表明,胎次的作用可能会因ER状态和绝经状态而改变。为了更清楚地了解SSA中胎次与乳腺癌之间的关系,需要对这些建议进行进一步的调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)
The association between parity and breast cancer has been widely investigated in high-income countries. However, in sub-Saharan African (SSA) region, only a few studies have investigated this association. The aim of this study was to critically review the available evidence, highlighting their strength and weakness, thereby providing a basis for more studies in SSA on the topic. A literature search in MEDLINE, Scopus, PubMed, Google Scholar, and reference list of published studies was conducted. Key case control and cohort studies published between 2000 and 2018 were selected for detailed review based on sample size, geographical distributions, and relevance of the findings. Nonanalytical studies were excluded. The findings were summarized using the tables and forest plots based on R Statistical Software version 3.4.0 (2017). This was primarily to provide visual overview of the reviewed studies and not necessarily to provide a pooled estimate. The conclusion was drawn by comparing the number of observed significant findings (assessed based on confidence intervals) with the number of nonsignificant findings across countries and SSA taking into considerations their strengths and weaknesses. Twenty-six case − control studies and 12 cohort studies across the four regions of the world North America, Europe, Asia, and Africa were reviewed. A reduced risk of breast cancer (especially estrogen receptor [ER] positive breast cancer) was observed in most studies, especially studies from high-income countries. While several studies that reported a nonsignificant observation in SSA were limited in sample size, the few that observed a reduced risk of breast with parity among all women were subject to confounding. Nevertheless, recent studies suggest that the role of parity may be modified by ER status and menopausal status. Further investigation of these suggestions will be needed for a clearer understanding of the relationship between parity and breast cancer in SSA.
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