20 年前发表的试验表明他莫昔芬对患有导管原位癌 (DCIS) 的女性有益；但随后内分泌治疗的采用率较低。我们估计了 2001 年至 2018 年间社区环境中患有 DCIS 的女性开始内分泌治疗的情况，反映了比之前的研究更近几年的诊断结果。该回顾性队列包括 2001 年至 2018 年间诊断出首次原发性 DCIS 的 20 岁成年女性，并随访至 2019 年，并加入了美国三个综合医疗保健系统之一。我们从 DCIS 诊断后 12 个月内的电子药房记录中收集了内分泌治疗配药（他莫昔芬、芳香酶抑制剂 [AI]）的数据。使用具有对数关联和泊松分布的广义线性模型，我们根据患者、肿瘤（包括雌激素受体 [ER] 状态）和治疗特征估计了随时间变化的内分泌治疗起始率。在 2020 名患有 DCIS 的女性中，有 587 名 (29%)诊断后 12 个月内开始内分泌治疗（1208 名 ER 阳性 DCIS 女性中的 36%）。在使用内分泌治疗的女性中，506 名 (86%) 开始使用他莫昔芬，81 名 (14%) 开始使用 AI。 2001 年至 2017 年间，开始接受年龄调整内分泌治疗的比例从 34% 下降至 21%； 2015 年至 2018 年间，人工智能的使用率从 8% 增加到 35%。不太可能开始内分泌治疗的女性为 ER 阴性或具有临界/未知或无 ER 测试结果、诊断时≥65 岁、黑人且未接受放射治疗。 三分之一的诊断为 DCIS 的女性开始内分泌治疗，并且使用量减少随着时间的推移。了解为什么适合接受内分泌治疗的女性不开始治疗对于最大限度地提高 DCIS 诊断后的无病生存率非常重要。© 2024。作者获得 Springer Science Business Media, LLC（Springer Nature 的一部分）的独家许可。

Trials demonstrating benefits of tamoxifen for women with ductal carcinoma in situ (DCIS) were published > 20 years ago; yet subsequent uptake of endocrine therapy was low. We estimated endocrine therapy initiation in women with DCIS between 2001 and 2018 in a community setting, reflecting more recent years of diagnosis than previous studies.This retrospective cohort included adult females ≥ 20 years diagnosed with first primary DCIS between 2001 and 2018, followed through 2019, and enrolled in one of three U.S. integrated healthcare systems. We collected data on endocrine therapy dispensings (tamoxifen, aromatase inhibitors [AIs]) from electronic pharmacy records within 12 months after DCIS diagnosis. Using generalized linear models with a log link and Poisson distribution, we estimated endocrine therapy initiation rates over time and by patient, tumor (including estrogen receptor [ER] status), and treatment characteristics.Among 2020 women with DCIS, 587 (29%) initiated endocrine therapy within 12 months after diagnosis (36% among 1208 women with ER-positive DCIS). Among women who used endocrine therapy, 506 (86%) initiated tamoxifen and 81 (14%) initiated AIs. Age-adjusted endocrine therapy initiation declined from 34 to 21% between 2001 and 2017; between 2015 and 2018, AI use increased from 8 to 35%. Women less likely to initiate endocrine therapy were ER-negative or had borderline/unknown or no ER test results, ≥ 65 years at diagnosis, Black, and received no radiotherapy.One-third of women diagnosed with DCIS initiated endocrine therapy, and use decreased over time. Understanding why women eligible for endocrine therapy do not initiate is important to maximizing disease-free survival following DCIS diagnosis.© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.