Naised ja kopsuvähk Jana Jaal onkoloogia vanemarst-õppejõud, dr. med.

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Presentation transcript:

Naised ja kopsuvähk Jana Jaal onkoloogia vanemarst-õppejõud, dr. med. SA Tartu Ülikooli Kliinikum, Tartu Ülikool

Suitsetamine (aktiivne ja passiivne) on suurimaks kopsuvähi riskiteguriks nii meestel kui naistel. Kuid…

…sellele vaatamata esinevad soolised erinevused kopsuvähi tekkes ning haiguse kulus.

Naiste haigestumus kopsuvähki sageneb * * vanuse järgi standarditud haigestumuskordajad 100 000 naise või mehe kohta National Cancer Institute

Naiste haigestumus kopsuvähki sageneb * vanuse järgi standarditud haigestumuskordajad (maailma standardrahvastik) 100 000 naise kohta GLOBOCAN 2009

Naistel esineb histoloogilise vormina sagedamini adenokartsinoomi Kopsuvähi histoloogiliste vormide jaotus Eesti meestel ja naistel ajaperioodil 2003-2007. Eesti Vähiregistri andmed.

Kopsuvähiga naiste seas on vähem suitsetajaid Hinnanguliselt on kopsuvähi haigete seas: mittesuitsetajaid mehi 10% mittesuitsetajaid naisi 20% Scagliotti et al. Nonsmall cell lung cancer in never smokers. Current Opinion in Oncology, 2009, 21:99-104.

Uus, naisi mõjutav kopsuvähi riskitegur: hormoonasendusravi menopausis 36588 peri- ja postmenopausis naist hõlmanud uuring. Hormoonasendusravi (östrogeen+progesteroon, >10a) suurendas naiste kopsuvähi tekkeriski ca 50%. Hormoonasendusravi saanud naistel avastati haigus rohkem levinud staadiumis võrreldes kontrollgrupiga. Slatore et al. Lung cancer and hormone replacement therapy: association in the vitamins and lifestyle study. J Clin Oncol 2010; 28(9):1540-6.

Uus, naisi mõjutav kopsuvähi riskitegur: hormoonasendusravi menopausis Chlebowski et al. Oestrogen plus progestin and lung cancer in postmenopausal women (Women's Health Initiative trial): a post-hoc analysis of a randomized controlled trial. Lancet 2009; 374:1243-51.

Uus, naisi mõjutav kopsuvähi riskitegur: hormoonasendusravi menopausis ER-α ER-β PR Raso et al. Immunohistochemical Expression of Estrogen and Progesterone Receptors Identifies a Subset of NSCLCs and Correlates with EGFR Mutation. Clin Cancer Res 2009;15(17):5359-68.

Kopsuvähiga naised elavad kauem Cerfolio RJ, Bryant AS, Scott E, et al. Women with pathologic stage I, II, and III non-small cell lung cancer have better survival than men. Chest 2006;130:1796-802.

Mida saame meie teha? Nõustada elanikkonda suitsetamisest loobumisel! Selgitada suitsetamise ja teiste riskifaktorite rolli kopsuvähi tekkes! Arstide järjepidev õpe! Mida saame meie teha? Teadustöö “Mitteväikerakulise kopsuvähi soolised erinevused haiguse tekkes ja kulus” Tartu Ülikool SA Tartu Ülikooli Kliinikum SA Põhja-Eesti Regionaalhaigla Tervise Arengu Instituut November 2010 Eesti Arsti erinumber “Kopsuvähk” Eesti Onkoloogide Selts Eesti Kopsuarstide Selts Eesti Torakaalkirurgide Selts

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