首页> 外文期刊>Obstetrics and Gynecology: Journal of the American College of Obstetricians and Gynecologists >Cancer risk in women using the levonorgestrel-releasing intrauterine system in Finland
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Cancer risk in women using the levonorgestrel-releasing intrauterine system in Finland

机译:芬兰使用左炔诺孕酮宫内节育系统的妇女患癌症的风险

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OBJECTIVE: To examine the association between premenopausal use of the levonorgestrel-releasing intrauterine system and cancer incidence in Finland with a special focus on endometrial adenocarcinoma. METHODS: All Finnish women aged 30-49 years using a levonorgestrel-releasing intrauterine system for treatment of menorrhagia in 1994-2007 (n=93,843) were identified from the National Reimbursement Registry and linked to the Finnish Cancer Registry data. The incidence of cancers in levonorgestrel-releasing intrauterine system users was compared with that in the general population. RESULTS: A total of 2,781 cancer cases were detected in levonorgestrel-releasing intrauterine system users during the follow-up of 855,324 women-years. The standardized incidence ratio (observed-to-expected ratio) for endometrial adenocarcinoma was 0.50 (95% confidence interval [CI] 0.35-0.70; 34 observed compared with 68 expected cases) after the first levonorgestrel-releasing intrauterine system purchase and 0.25 (95% CI 0.05-0.73; three observed compared with 12 expected cases) after two purchases. The standardized incidence ratio for ovarian cancer was 0.60 (95% CI 0.45-0.76; 59 observed compared with 99 expected cases), for pancreatic cancer 0.50 (95% CI 0.28-0.81; 15 observed compared with 30 expected cases), and for lung cancer 0.68 (95% CI 0.49-0.91; 43 observed compared with 63 expected cases). The standardized incidence ratio for breast cancer among all levonorgestrel-releasing intrauterine system users was 1.19 (95% CI 1.13-1.25; 1,542 observed compared with 1,292 expected cases). CONCLUSION: The levonorgestrel-releasing intrauterine system may have a protective effect against endometrial malignant transformation. Using the levonorgestrel-releasing intrauterine system for treatment of menorrhagia during reproductive years was associated with a lower incidence of endometrial, ovarian, pancreatic, and lung cancers than expected. Levonorgestrel-releasing intrauterine system use was associated with a higher than expected incidence of breast cancer.
机译:目的:探讨绝经前使用左炔诺孕酮的宫内节育系统与芬兰的癌症发生率之间的关系,特别关注子宫内膜腺癌。方法:1994-2007年间使用左炔诺孕酮子宫内释放系统治疗月经过多的所有30-49岁芬兰妇女(n = 93,843)均从国家报销登记处进行鉴定,并与芬兰癌症登记处的数据相关联。比较了左炔诺孕酮释放子宫内系统使用者与普通人群中癌症的发生率。结果:855,324妇女年的随访期间,在左炔诺孕酮释放子宫内系统使用者中共检测到2,781例癌症病例。首次购置左炔诺孕酮子宫内系统后,子宫内膜腺癌的标准化发生率(观察到预期的比率)为0.50(95%置信区间[CI] 0.35-0.70;与68例预期病例相比较,观察到34),而0.25(95 %CI 0.05-0.73;两次购买后观察到三个,与12个预期病例相比。卵巢癌的标准化发病率是0.60(95%CI 0.45-0.76;观察到59,与99个预期病例比较),胰腺癌0.50(95%CI 0.28-0.81;与30个预期病例相比,观察到15)癌症0.68(95%CI 0.49-0.91;观察到43例,与63例预期病例相比)。在所有释放左炔诺孕酮的子宫内系统使用者中,乳腺癌的标准化发病率是1.19(95%CI 1.13-1.25;观察到1,542,与预期的1,292例相比)。结论:左炔诺孕酮宫内释放系统可能对子宫内膜恶变具有一定的保护作用。使用左炔诺孕酮释放子宫内系统治疗生殖期月经过多与子宫内膜癌,卵巢癌,胰腺癌和肺癌的发生率低于预期有关。左炔诺孕酮释放子宫系统的使用与乳腺癌的发生率高于预期有关。

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