激素治疗.ppt

* * 评价乳腺癌风险的混杂因素，对讨论妇女使用或不使用激素治疗发生乳腺癌的绝对风险有帮助，To address patients’ confusion regarding breast cancer risk, it may be helpful to discuss a woman’s absolute risk of breast cancer, with or without HRT. 在约定人群中一种疾病的全部发病率为绝对风险。例如Feuer和他的同事们估计50岁的妇女在60岁以前发生乳腺癌的机会为2.8%。因此，每100位妇女中，2.8人有发生乳腺癌的风险。Absolute risk is the overall incidence of a disease in a given population. For example, Feuer and colleagues estimated that a 50-year-old woman has a 2.8% chance of developing breast cancer before she turns 60 years of age. Therefore, among 100 women, 2.8 are at risk for breast cancer. American Cancer Society, Surveillance Research, 2001. Breast Cancer Facts and Figures 2001–2002. Available at: HRTtp///downloads/STT/BrCaFF2001.pdf. * * 相对风险不同于绝对风险和归因危险度，不能象绝对风险一样解释。相对风险是暴露于危险因素与未暴露于危险因素发生疾病风险的比例，与人群该疾病的全部发病率无关。Relative risk is different from absolute and attributable risk and should not be interpreted as such. Relative risk is the ratio of the risk of disease among those exposed to a risk factor to the risk among those who were not exposed and is independent of the overall incidence of disease in the population. WHI报道激素治疗发生乳腺癌的相对风险为1.24。使用HRT的妇女与安慰剂组妇女相比，乳腺癌风险增加24% .1 。因此，50岁妇女使用HRT5.2年到60岁时发生乳腺癌的绝对风险是每100人中3.5人.1,2 。The WHI reported that HRT use was associated with an RR of breast cancer of 1.24. Women using HRT experienced a 24% increase in the risk of breast cancer compared with women taking placebo.1 Therefore, the absolute risk of breast cancer by age 60 years among 50-year-old women taking HRT for 5.2 years is 3.5 per 100 HRT users.1,2 对使用HRT的归因危险度的讨论可以帮助患者预计使用HRT发生乳腺癌的风险。归因危险度是指患者暴露于潜在危险因素发生疾病的额外风险，它超过了没有暴露潜在危险因素的风险。在队列研究中，评价乳腺癌风险和使用HRT情况，归因危险度是通过使用者和未使用者间发病率的差异进行计算的。A discussion of the attributable risk associated with HRT also may help patients put breast cancer risk with HRT into perspective. Attributable risk refers to the excess risk of disease in patients exposed to a potential risk factor, above and beyond the risk expected in patients not exposed to the potential