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Use of systemic glucocorticoids and risk of breast cancer in a prospective cohort of postmenopausal women.
Cairat, Manon; Al Rahmoun, Marie; Gunter, Marc J; Heudel, Pierre-Etienne; Severi, Gianluca; Dossus, Laure; Fournier, Agnès.
Afiliação
  • Cairat M; Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.
  • Al Rahmoun M; Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Exposome and heredity team, CESP, F-94805, Villejuif, France.
  • Gunter MJ; Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.
  • Heudel PE; Medical Oncology Department, Centre Léon Bérard, Lyon, France.
  • Severi G; Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Exposome and heredity team, CESP, F-94805, Villejuif, France.
  • Dossus L; Department of Statistics, Computer Science and Applications "G. Parenti" (DISIA), University of Florence, Florence, Italy.
  • Fournier A; Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.
BMC Med ; 19(1): 186, 2021 08 02.
Article em En | MEDLINE | ID: mdl-34340701
BACKGROUND: Glucocorticoids could theoretically decrease breast cancer risk through their anti-inflammatory effects or increase risk through immunosuppression. However, epidemiological evidence is limited regarding the associations between glucocorticoid use and breast cancer risk. METHODS: We investigated the association between systemic glucocorticoid use and breast cancer incidence in the E3N cohort, which includes 98,995 women with information on various characteristics collected from repeated questionnaires complemented with drug reimbursement data available from 2004. Women with at least two reimbursements of systemic glucocorticoids in any previous 3-month period since January 1, 2004, were defined as exposed. We considered exposure as a time-varying parameter, and we used multivariable Cox regression models to estimate hazard ratios (HRs) of breast cancer. We performed a competing risk analysis using a cause-specific hazard approach to study the heterogeneity by tumour subtype/stage/grade. RESULTS: Among 62,512 postmenopausal women (median age at inclusion of 63 years old), 2864 developed breast cancer during a median follow-up of 9 years (between years 2004 and 2014). Compared with non-exposure, glucocorticoid exposure was not associated with overall breast cancer risk [HR = 0.94 (0.85-1.05)]; however, it was associated with a higher risk of in situ breast cancer and a lower risk of invasive breast cancer [HRinsitu = 1.34 (1.01-1.78); HRinvasive = 0.86 (0.76-0.97); Phomogeneity = 0.01]. Regarding the risk of invasive breast cancer, glucocorticoid exposure was inversely associated with oestrogen receptor (ER)-positive breast cancer [HRER+ = 0.82 (0.72-0.94); HRER- = 1.21 (0.88-1.66); Phomogeneity = 0.03]; it was also inversely associated with the risk of stage 1 or stage 2 tumours but positively associated with the risk of stage 3/4 breast cancers [HRstage1 = 0.87 (0.75-1.01); HRstage2 = 0.67 (0.52-0.86); HRstage3/4 = 1.49 (1.02-2.20); Phomogeneity = 0.01]. CONCLUSION: This study suggests that the association between systemic glucocorticoid use and breast cancer risk may differ by tumour subtype and stage.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Glucocorticoides Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Middle aged Idioma: En Revista: BMC Med Assunto da revista: MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: França País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Glucocorticoides Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Middle aged Idioma: En Revista: BMC Med Assunto da revista: MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: França País de publicação: Reino Unido