臺灣女性乳癌與荷爾蒙補充治療之相關性

10.6666/ClinMed.2017.80.3.094

劉瑞瑤；陳曾基；黃信彰

乳癌(breast cancer) ； 停經後荷爾蒙補充治療(menopausal hormone replacement therapy) ； 全民健康保險研究資料庫(National Health Insurance Research Database)

臨床醫學月刊

80卷3期（2017 / 09 / 29）

504 - 506

繁體中文

臺灣女性乳癌的發生率逐年上升，已為臺灣發生率最高的癌症。與西方國家不同的是，臺灣的老年世代乳癌發生率很低，而年輕世代的乳癌發生率則趨近西方國家。以全民健康保險研究資料庫的抽樣歸人檔來分析臺灣女性乳癌與停經後荷爾蒙補充治療的相關性，發現荷爾蒙補充時間越長者，乳癌的發生率越高。從開始補充荷爾蒙至產生乳癌，約需三年的誘導期。合併使用雌激素與黃體素長達8年者，罹患乳癌的風險增為兩倍。單用雌激素者，乳癌風險並無顯著增加。對臺灣中年婦女而言，平均每1,000人年的荷爾蒙補充治療就會增加1.5位乳癌個案，有10.3%的乳癌可歸因於荷爾蒙補充治療。雖然臺灣女性停經後荷爾蒙補充治療的使用率自2002年美國國家衛生研究院發表「婦女健康關懷研究」結果後便逐年下降，但乳癌的發生率仍逐年上升，內生性荷爾蒙的增加或環境荷爾蒙的影響仍待探討。

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