作者:Jonas Manjer
DOI:10.1080/110241500447227
日期:2000.10.20
ObjectiveTo compare survival of patients with breast cancer who had never smoked, were smokers, and who were ex-smokers.DesignObservational study.SettingCity of Malmö, Sweden.Patients792 patients with breast cancer diagnosed between 1977–1986 in the Malmö mammographic screening trial.InterventionsFollow-up of breast cancer cases through record-linkage with the Swedish Cause of Death Registry.Main outcome measuresDeath from breast cancer. Relative risk (RR) with 95% confidence interval (CI) of death from breast cancer was calculated for different smoking groups using Cox's proportional hazards analysis.ResultsDuring a mean follow-up of 12.1 years, 145 patients died of breast cancer. Breast cancer mortality was 1347/105 person-years in those who had never smoked, 1941/105 in smokers, and 1493/105 in ex-smokers. The crude RR for smokers and ex-smokers, compared with those who had never smoked were 1.44 (1.01 to 2.06) and 1.13 (0.66 to 1.94), respectively. The RR associated with smoking remained significant after adjustment for age and stage at diagnosis, 2.14 (1.47 to 3.10), and other potential confounders.ConclusionsSurvival after breast cancer was, as expected, strongly related to stage at diagnosis. However, stage by stage there was considerable variation between individual patients. We conclude that differences with regard to exposure to smoking contribute to this heterogeneity.
Objective 旨在比较从未吸烟、吸烟和已戒烟的乳腺癌患者的生存情况。Design 这是一项观察性研究。Setting 研究地点位于瑞典马尔默市。Patients 研究对象为1977年至1986年间在马尔默乳腺筛查试验中被诊断为乳腺癌的792名患者。Interventions 通过与瑞典死因登记库的记录关联,对乳腺癌病例进行随访。Main outcome measures 主要观察指标是死于乳腺癌的情况。利用Cox比例风险分析计算不同吸烟群体死于乳腺癌的相对风险(RR)及其95%置信区间(CI)。Results 在平均12.1年的随访期间,145名患者死于乳腺癌。从未吸烟者、吸烟者和已戒烟者的乳腺癌死亡率分别为每10万人年1347例、1941例和1493例。与从未吸烟者相比,吸烟者和已戒烟者的粗略相对风险分别为1.44(1.01至2.06)和1.13(0.66至1.94)。在调整年龄和诊断分期以及其他潜在混杂因素后,与吸烟相关的相对风险仍然显著,为2.14(1.47至3.10)。Conclusions 如预期的那样,乳腺癌后的生存强烈依赖于诊断时的分期。然而,各分期之间个体患者的生存情况存在显著差异。我们得出结论,关于吸烟暴露的差异对此异质性有贡献。