饮酒与膀胱癌关系的全人群病例对照研究

Alcohol consumption and bladder cancer risk: a population-based case control study in urban Shanghai

目的：探讨饮酒与膀胱癌发生的关系。方法：采用金人群为基础的病例对照研究，共调查1996年1月1日～1998年12月31日期间确诊的上海市区膀胱癌新发病例608例，健康人群对照607例。采用非条件logistic回归分析，调整吸烟等可能的混杂因素，以估计饮酒对膀胱癌发生的危险度及其95％可信区间。结果：与不饮酒者相比，男、女性饮酒者患膀胱癌相对危险度分别是1．22（95％CI：0．94～1．59）、0．50（95％CI：0．13～1．90）。男性随总酒精摄入量增加患膀胱癌的危险有增加趋势，OR值分别为：1．10（1～80g／d）和1．56（〉80g／d）（趋势检验P=0．043）。男性总酒精摄入量与饮酒年限的联合作用分析表明，与不饮酒者相比，总酒精摄入量超过80g／d、饮酒年限超过40年者患膀胱癌危险度为2．11（95％CI：1．11～4．01）。将饮酒分3层、吸烟分4层进行男性饮酒与吸烟的联合作用分析，结果显示总酒精摄入量〉80g／d且吸烟≥35包年者的OR值为2．78（95％CI：1．46～5．28）。未发现各饮酒种类与男性膀胱癌有显著关联。在不吸烟男性组中的分析显示，饮酒习惯的OR值均没有统计学意义。结论：饮酒可能与男性膀胱癌有一定联系，但作用较弱，似乎主要表现为对吸烟男性的作用。

Objective：To identify the relationship between alcohol consumption and risk of bladder cancer in urban Shanghai. Methods：Patients with bladder cancer identified in urban Shanghai from 1996 Jan 1 to 1998 Dec 31 （n= 608） were recruited. Age- and sex-matched population controls （71= 607） were interviewed from 1996 Jan 1 to 1999 Dec 31. Unconditional logistic regression was used to calculate odds ratios （ORs） and their 95% confidence interval （95%CI）,adjusted for smoking and other confounding factors. Results：The ORs for alcohol drinkers were 1.22（95%CI：0.94-1.59） in men and 0.50（95%Cl：0. 13-1.90） in women. Male subjects with heavy daily alcohol intake had a significantly elevated risk of bladder cancer [OR= 1.10 （1-80 g/ d） and 1.56 （〉80 g/d）,（P for trend：0.043）]. When the overall alcohol intake and drinking history was combined,bladder cancer risk was increased in subjects with a heavy alcohol intake （〉80 g/d） or long drinking history （〉10 years） （OR：2.11, 95Y00CI：1. 11-4.01）. After combined 2 stage drinking and 4-stage smoking models,the OR was 2. 78 （95%CI：1. 46-5.28） for subjects with daily alcohol intake of 〉80 g and heavy smoking of 35 or more packet years. No significant association was observed between different kinds of beverage and risk of bladder cancer in men. Risk of bladder cancer was not related to alcohol intake habit in male non smoking subjects. Conclusion： There was a weak positive association between alcohol consumption and risk of bladder cancer for male subjects, especially for smokers.