FERTILITY DRUG USE AND RISK OF OVARIAN CANCER

生育药物的使用和卵巢癌的风险

• 批准号: 2392462
• 负责人: MARY ANNE ROSSING
• 金额: $ 28.61万
• 依托单位: FRED HUTCHINSON CANCER RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-04-01 至 2000-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2392462
• 关键词: blood chemistry; brca gene; cancer risk; case history; clinical research; clomiphene; drug adverse effect; drug related neoplasm /cancer; female; fertility promoting drug; human genetic material tag; human middle age (35-64); human population study; human subject; interview; neoplasm /cancer genetics; ovary neoplasms; reproductive system disorder chemotherapy; women's health; young adult human (21-34)

Currently, more than one million U.S. women each year seek treatment for infertility. This number continues to increase, as more women delay childbirth until later ages, adoption becomes increasingly difficult, and the recognition of new, sophisticated technologies for assisted reproduction becomes more widespread. Recently, there has been increasing concern regarding the potential neoplastic effects of the powerful ovulatory stimulants used in the treatment of infertility. In a recently completed study, we observed a strong increase in risk of ovarian cancer associated with use of clomiphene citrate for greater than one year (adjusted RR=11.1, 95% CI 1.5-82.3). The biological plausibility of an effect of ovulation-inducing agents on risk of ovarian cancer, the increasing prevalence of exposure to these drugs, and the limited data currently available all indicate a strong need for further research. We propose to conduct a population-based case-control study examining risk of ovarian cancer associated with the use of fertility drugs, including ovulation-inducing agents such as clomiphene citrate and exogenous gonadotropins. Cases will be women aged 35-54 diagnosed with ovarian cancer from May 1 1995- April 30, 1998 in 3 study sites. Controls will be similarly aged women selected by random digit dialing in each of the study sites. Details regarding medical evaluation and/or treatment for infertility will be elicited at in-person interview, as will information regarding family cancer history and other known and potential risk factors for ovarian cancer. Information regarding the types, dosage and duration of infertility treatments received will also be abstracted from infertility clinic medical records. Blood samples will be collected at the time of interview and white cells will be stored to enable future genetic testing (e.g., for the presence of the BRCA1 gene) to examine the effect of inherited genetic susceptibility to ovarian cancer on the relationship between fertility drug use (as well as other environmental factors) and risk of this disease. Our proposed study is efficient as it will use as controls, at no cost to this study, approximately 2000 women interviewed as controls for an MCHD- funded multi-center case-control study of breast cancer (the Women's CARE study) which will be conducted concurrently with and in the same geographic areas as this study. Further, the population-based case-control design of our study will enable us to assess whether infertile women without exposure to ovulation-inducing drugs are at an increased risk of ovarian cancer, or, alternatively, whether any increase in risk of ovarian cancer associated with infertility may be due to the use of fertility drugs.

目前，每年有超过一百万的美国妇女寻求治疗 不育。随着越来越多的女性延迟，这个数字继续增加 分娩直到后来，采用变得越来越困难，并且 认识新的，先进的技术用于辅助技术 繁殖变得更加普遍。最近，有所增加 对强大的潜在肿瘤作用的关注 用于治疗不育症的排卵刺激剂。在最近 完成的研究，我们观察到卵巢癌风险有很大增加 与使用克罗米芬柠檬酸盐超过一年有关 （调整后的RR = 11.1，95％CI 1.5-82.3）。一个生物学的合理性 排卵剂对卵巢癌风险的影响， 增加暴露于这些药物的患病率和有限的数据 目前可用的所有内容均表明进一步研究的需求。 我们建议进行基于人群的病例对照研究检查风险 与使用生育药物有关的卵巢癌，包括 排卵剂，例如柠檬酸氯芬和外源性剂 促性腺激素。病例将是35-54岁的妇女，被诊断为卵巢 1995年5月1日至1998年4月30日的癌症在3个研究地点。控件将是 在每个研究中，通过随机数字拨号选出的年龄妇女类似 站点。有关医学评估和/或治疗的详细信息 不孕症将在面对面的访谈中引起 关于家庭癌症病史以及其他已知和潜在的危险因素 用于卵巢癌。有关类型，剂量和持续时间的信息 收到的不育治疗也将从 不育诊所病历。血样将在 面试时间和白细胞将被存储以实现未来的遗传 测试（例如，对于BRCA1基因的存在）来检查效果 对这种关系的遗传遗传易感性 在生育药物使用（以及其他环境因素）和 这种疾病的风险。 我们提出的研究效率很高，因为它将用作控制 这项研究，大约有2000名妇女作为MCHD-的对照。 资助的乳腺癌多中心病例对照研究（妇女护理 研究）将同时进行和同时进行 地理区域如本研究。此外，基于人群的病例对照 我们的研究设计将使我们能够评估不育女性 没有暴露于排卵的药物没有诱导药物的风险 卵巢癌，或者，卵巢风险是否增加 与不育有关的癌症可能是由于使用了生育能力 毒品。