Epidemiologic risk factors for breast cancer related to menopausal status in Indonesia

Abstract

Untuk meneliti faktor risiko kanker payudara yang berkaitan dengan status menopause, dilakukan penelitian kasus kontrol pada rumah sakit di Indonesia. Pada 300 kasus dan 600 kontrol yang berpasangan menurul umur dan keadaan sosial ekonomi dilakukan wawancara . Kasus dan kontrol dikelompokkan berdasarkan status menopausenya dan dianalisis terpisah. Diperoleh temuan-temuan bermakna berikut ini.Di antara penderita kanker payudara pra menopause ditemukan peningkatan risikopada yang mengalami trauma payudara (RR: 2,62; 95% JK: 1,09-6,31), menggunakan kontrasepsi oral (4,96; 1,51-16,24), mengkonsumsi susu (1,81; 1,01-3,35 konsumsi tiap hari versus nir konsumsi), makan buah sega r (2,42; 1,16-5,05, 3-4x per minggu versus kurang dari seka li per minggu). Penurunan risiko ditemukan pada wanita pengkonsumsi sayuran tiap hari (0,34; 0,15-0,77, konsumsi tiap hari versus tidak tiap hari). Di antara penderita kanker payudara pasca menopause ditemukan peningkatan risiko pada wanita dengan usia menard1e 15 tahun atau lebih (2,25 ·1,35-3,76), haid teratur setelah usia 30 tahun (4,61-· 2,45-8,67), konsumsi susu (5,84; 2,92-11,66, konsumsi tiap hari versus nir konsumsi). Penurunan risiko ditemukan pada wanita yang cerai atau janda (0,33; 0,18-0,58), jumlah melahirkan hidup atau bayi yang disusuinya tinggi (0,32; 0,13-0,76), menyusui 6 atau lebih bayi versus tidak menyusui). Abstract To clarify the risk factors of breast cancer in premenopausal and postmenopausal women, a hospital-based case-control study was conducted in Indonesia. Three hundred inciden.t cases were inlerviewed and 600 controls were selected, matching for age and socio-economic class. Cases and controls were divided according to their menopausal status and analyzed separately. Following significant findi ngs were revea led. For premenopausal breast cancer, an increased risk was detected in women with breast trauma (adjus ted RR: 2.62; 95% Cl: 1.09-6.31), oral contraceptive u e (4.96,- 1.51-16.24), milk consumption (1.81; 1.01-3.35, daily intake vs no intake), fresh frui ts intake (2-42; 1.16-5.05, 3-4 times/week vs less than once/week intake). A decreased risk was detected in women with cooked-vegetable intake (0.34; 0.15-0.77, daily intake vs not daily intake). For postmenopausal breast cancer, an increased risk wasfound in women having menarche at the age of 15 years or over (2.25; 1.35-3.76), regular menstruation after thirty years old (4.61; 2.45-8 .67), milk consumption (5.84; 2.92-11.66, daily intake vs no intake), and a decreased risk in women who were divorced or widowed (0.33; 0. 18-0.58), and whose number of live birth or breast-fed children was high (0.32; 0.13-0.76, six or more breast-fed children vs no breast-fed child). Keywords :case-control study, pr emenopausal women, p ost menopausal women, breast cancer, risk factors