襄阳市良性乳腺疾病和乳腺癌现况及影响因素分析

目的了解湖北省襄阳市适龄妇女良性乳腺疾病和乳腺癌的流行情况及影响因素,为乳腺相关疾病的防控提供依据。方法襄阳市于2017年对辖区12个市县区的适龄妇女进行乳腺癌筛查并收集了筛查人群的流行病学资料,计算良性乳腺疾病及乳腺癌的检出率,使用Logistic回归分析影响良性乳腺疾病及乳腺癌的因素。结果共有316524名妇女参与了乳腺癌筛查,检出良性乳腺疾病44097例(13.93%),乳腺癌80例(25.27/10万)。良性乳腺疾病的主要危险因素是:年龄30~49岁,以49岁以上妇女为参照,OR=1.26,95%CI:1.21~1.30;文化程度高中及以上,以初中及以下为参照,OR=2.15,95%CI:2.10~2.20;有乳腺癌家族史,OR=1.72,95%CI:1.51~1.96;其他女性生殖系统肿瘤家族史,OR=2.05,95%CI:1.77~2.37;初潮年龄<12岁,OR=1.42,95%CI:1.37~1.48;月经持续时间<4天,OR=1.32,95%CI:1.26~1.39;月经周期<21天,OR=1.21,95%CI:1.01~1.45;月经周期>35天,OR=1.35,95%CI:1.18~1.54;绝经,OR=2.02,95%CI:1.88~2.17;绝经后使用雌激素治疗,OR=1.40,95%CI:1.12~1.75;孕次>3次,OR=1.16,95%CI:1.13~1.19;初产年龄>29岁,OR=1.11,95%CI:1.05~1.18。乳腺癌的主要危险因素:有乳腺癌家族史,OR=10.17,95%CI:3.67~28.17;年龄,随着年龄的增加,乳腺癌的发病风险增高,OR=1.39,95%CI:1.20~1.61;文化程度为高中及以上,以初中及以下为参照,OR=1.83,95%CI:1.11~3.01;而初产年龄<25岁则是乳腺癌的保护因素,OR=0.53,95%CI:0.33~0.84。结论襄阳市乳腺癌和良性乳腺疾病的发病率居于中等水平。积极控制高危因素、定期筛查并及时治疗乳腺相关疾病,有助于降低乳腺癌的疾病负担,提升妇女的健康质量。

The prevalence of breast cancer and benign breast disease and their related risk factors in Xiangyang

Objective To understand the prevalence and risk factors of breast cancer and benign breast disease among women of childbearing age in Xiangyang city,Hubei province,to provide evidence for the prevention and control of breast related diseases.Methods In 2017,breast cancer screening on women of childbearing age in 12 cities,counties,and districts under jurisdiction of Xiangyang City was carried out and epidemiological data of the screening population was collected,the detection rate of benign breast diseases and breast cancer was calculated,and Logistic regression analysis was used to analyze risk factors of benign breast disease and breast cancer.Results A total of 316,524 women participated in breast cancer screening,among which 44097 cases(13.93%)of benign breast disease and 80 cases(25.27/100,000)of breast cancer were detected.The main risk factors for benign breast disease were age 30-49 years(compared with women>49 years of age,OR=1.26,95%CI:1.21-1.30),higher education(compared with women with junior high school and below,OR=2.15,95%CI:2.10-2.20),family history of breast cancer(OR=1.72,95%CI:1.51-1.96),other female reproductive system tumors(OR=2.05,95%CI:1.77-2.37),age at menarche<12 year(OR=1.42,95%CI:1.37-1.48),menstrual duration<4 days(OR=1.32,95%CI:1.26-1.39),menstrual cycle<21 days(OR=1.21,95%CI:1.01-1.45),menstrual cycle>35 days(OR=1.35,95%CI:1.18-1.54),menopause(OR=2.02,95%CI:1.88-2.17),postmenopausal estrogen therapy(OR=1.40,95%CI:1.12-1.75),pregnancy times>3 times(OR=1.16,95%CI:1.13-1.19),and the age at first delivery>29 years(OR=1.11,95%CI:1.05-1.18).The main risk factors for breast cancer were family history of breast cancer(OR=10.07,95%CI:3.67-28.17),age,as the age increases,the risk of breast cancer increases(OR=1.39,95%CI:1.20-1.61),education with high school and above(compared with junior high school and below,OR=1.83,95%CI:1.11-3.01),but the age of first birth<25 years was a protective factor for breast cancer(OR=0.53,95%CI:0.33-0.84).Conclusion The incidence of breast cancer and benign breast disease in Xiangyang city is at a moderate level.Active control of high-risk factors,regular screening and timely treatment of breast related diseases contribute to reduce the burden of breast cancer and improve women’s health.