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Abstract：
BACKGROUND: To investigate the occurrence of previous cancer diagnoses in women suffering from premature ovarian insufficiency (POI) and compare it with the general population, shedding light on the association between cancer, cancer treatments, and POI.
METHODS: We conducted a nationwide case-control study based on registry data from various sources, including the Social Insurance Institution, Finnish Population Information System, and Finnish Cancer Registry spanning from 1953 to 2018. Our participants comprised all women in Finland who, between 1988 and 2017, received hormone replacement therapy reimbursement for ovarian insufficiency before the age of 40 years (n = 5221). Controls, matched in terms of age and municipality of residence, were selected from the Finnish Population Information System (n = 20 822). Our main exposure variable was a history of cancer diagnosis preceding the diagnosis of POI. We analyzed odds ratios (OR) to compare the prevalence of previous cancers in women with POI with that in controls, stratifying results based on cancer type, age at cancer diagnosis, and the time interval between cancer diagnosis and POI. We also assessed changes in OR for previous cancer diagnoses over the follow-up period.
RESULTS: Out of the women diagnosed with POI, 21.9% had previously been diagnosed with cancer, resulting in an elevated OR of 36.5 (95% confidence interval [CI] 30.9 to 43.3) compared with 0.8% of the controls. The risk of developing POI was most pronounced during the first 2 years following a cancer diagnosis, with an OR of 103 (95% CI 74.1 to 144). Importantly, this risk remained elevated even when the time interval between cancer and POI exceeded 10 years, with an OR of 5.40 (95% CI 3.54 to 8.23).
CONCLUSIONS: This study reveals that 21.9% of women with POI have a history of cancer, making the prevalence of cancer among these women 27.5 times higher than age-matched controls in the Finnish population. The risk of developing POI is most substantial in the first 2 years following a cancer diagnosis. These findings underscore the role of cancer treatments as an etiological factor for POI and emphasize the importance of recognizing the risk of POI in cancer survivors for early diagnosis and intervention.
METHODS: We conducted a nationwide case-control study based on registry data from various sources, including the Social Insurance Institution, Finnish Population Information System, and Finnish Cancer Registry spanning from 1953 to 2018. Our participants comprised all women in Finland who, between 1988 and 2017, received hormone replacement therapy reimbursement for ovarian insufficiency before the age of 40 years (n = 5221). Controls, matched in terms of age and municipality of residence, were selected from the Finnish Population Information System (n = 20 822). Our main exposure variable was a history of cancer diagnosis preceding the diagnosis of POI. We analyzed odds ratios (OR) to compare the prevalence of previous cancers in women with POI with that in controls, stratifying results based on cancer type, age at cancer diagnosis, and the time interval between cancer diagnosis and POI. We also assessed changes in OR for previous cancer diagnoses over the follow-up period.
RESULTS: Out of the women diagnosed with POI, 21.9% had previously been diagnosed with cancer, resulting in an elevated OR of 36.5 (95% confidence interval [CI] 30.9 to 43.3) compared with 0.8% of the controls. The risk of developing POI was most pronounced during the first 2 years following a cancer diagnosis, with an OR of 103 (95% CI 74.1 to 144). Importantly, this risk remained elevated even when the time interval between cancer and POI exceeded 10 years, with an OR of 5.40 (95% CI 3.54 to 8.23).
CONCLUSIONS: This study reveals that 21.9% of women with POI have a history of cancer, making the prevalence of cancer among these women 27.5 times higher than age-matched controls in the Finnish population. The risk of developing POI is most substantial in the first 2 years following a cancer diagnosis. These findings underscore the role of cancer treatments as an etiological factor for POI and emphasize the importance of recognizing the risk of POI in cancer survivors for early diagnosis and intervention.
摘要：
背景：为了调查卵巢早衰（POI）女性既往癌症诊断的发生情况，并将其与普通人群进行比较，揭示癌症之间的联系，癌症治疗,和POI。
方法：我们根据各种来源的注册数据进行了全国性的病例对照研究，包括社会保险机构，芬兰人口信息系统，和芬兰癌症登记处从1953年到2018年。我们的研究对象包括芬兰的所有女性，在1988年至2017年期间,患者在40岁之前接受了卵巢功能不全的激素替代疗法报销(n=5221).控件,在年龄和居住城市方面相匹配，从芬兰人口信息系统中选择(n=20822)。我们的主要暴露变量是POI诊断之前的癌症诊断史。我们分析了比值比（OR），以比较患有POI的女性与对照组中先前癌症的患病率，根据癌症类型对结果进行分层，癌症诊断的年龄，以及癌症诊断和POI之间的时间间隔。我们还评估了随访期间先前癌症诊断的OR变化。
结果：在被诊断为POI的女性中，21.9%以前被诊断出患有癌症，与0.8％的对照相比，OR升高了36.5（95％置信区间[CI]30.9至43.3）。发生POI的风险在癌症诊断后的前2年内最为明显。OR为103（95%CI74.1至144）。重要的是,即使癌症和POI之间的时间间隔超过10年，这种风险仍然升高，OR为5.40（95%CI3.54至8.23）。
结论：这项研究显示，21.9%的POI女性有癌症史，使这些女性的癌症患病率比芬兰人口中年龄匹配的对照组高27.5倍。发生POI的风险在癌症诊断后的前2年内最为显著。这些发现强调了癌症治疗作为POI病因因素的作用，并强调了认识到癌症幸存者POI风险对早期诊断和干预的重要性。
方法：我们根据各种来源的注册数据进行了全国性的病例对照研究，包括社会保险机构，芬兰人口信息系统，和芬兰癌症登记处从1953年到2018年。我们的研究对象包括芬兰的所有女性，在1988年至2017年期间,患者在40岁之前接受了卵巢功能不全的激素替代疗法报销(n=5221).控件,在年龄和居住城市方面相匹配，从芬兰人口信息系统中选择(n=20822)。我们的主要暴露变量是POI诊断之前的癌症诊断史。我们分析了比值比（OR），以比较患有POI的女性与对照组中先前癌症的患病率，根据癌症类型对结果进行分层，癌症诊断的年龄，以及癌症诊断和POI之间的时间间隔。我们还评估了随访期间先前癌症诊断的OR变化。
结果：在被诊断为POI的女性中，21.9%以前被诊断出患有癌症，与0.8％的对照相比，OR升高了36.5（95％置信区间[CI]30.9至43.3）。发生POI的风险在癌症诊断后的前2年内最为明显。OR为103（95%CI74.1至144）。重要的是,即使癌症和POI之间的时间间隔超过10年，这种风险仍然升高，OR为5.40（95%CI3.54至8.23）。
结论：这项研究显示，21.9%的POI女性有癌症史，使这些女性的癌症患病率比芬兰人口中年龄匹配的对照组高27.5倍。发生POI的风险在癌症诊断后的前2年内最为显著。这些发现强调了癌症治疗作为POI病因因素的作用，并强调了认识到癌症幸存者POI风险对早期诊断和干预的重要性。
