女性乳腺癌危险因素及其变化

The Risk Factors and Their Changes in Breast Cancer

目的探讨女性乳腺癌的危险因素及其变化,为有效防制乳腺癌发生及发展提供科学依据。方法(1)危险因素研究。通过1:1病例对照方法,调查某市2002～2003年新发女性乳腺癌患者,调查内容主要有生理因素、生育因素、环境因素、精神心理因素和生活方式等,统计分析方法为条件logistic回归分析。(2)危险因素变化研究。将在中分析获得的危险因素与已有的Meta分析结果进行比较,了解危险因素的变化情况。结果(1)单因素分析结果表明,有12个暴露因素与该市女性乳腺癌发病有关,多因素分析获得的主要危险因素有乳腺良性疾病史、职业接触、性格内向、高脂饮食、睡觉时不摘文胸。(2)部分乳腺癌危险因素发生变化,其中以职业接触、高脂饮食和睡觉时不摘文胸表现明显。结论乳腺癌发病及其危险因素的变化是生物因素、心理因素和社会行为因素综合作用的结果,要有效控制乳腺癌,必须采取综合措施。

Objective To explore the risk factors and their changes in breast cancer for preventing and controlling the occurrence and development of breast cancer effectively. Methods （ 1 ） Research of risk factors. The newly diagnosed patients with breast cancer in one city between 2002 and 2003 were investigated with 1 ： 1 case-control study. The main involved contents were physiological factor, bearing factor, environmental factor, mental and psychological factor, fife-style factor, etc. The statistical method of conditional logistic regression was used. Furthermore, model diagnosis and interaction between factors were considered. （2） Study on the changes of the risk factors. The changes were observed by comparing the risk factors in this study with the results of our previous Meta analysis on breast cancer. Results （ 1 ） The results showed from single-factor analysis that the risk factors included high-fat diet, psychic depression, inner character, occupation contact, menstrual cycle disorder, breast benign lesion, family history of breast tumor, brassiere tight-wearing, brassiere wearing when sleeping. Meanwhile, bean diet, tea-drinking and child bearing were protecting factors. It was indicated with multiple-factor analysis that the main risk factors of breast cancer were breast benign lesions, occupation contact,inner character,high-fat diet and brassiere wearing when sleeping. The model was well-fitting and the interaction items did not affect the model. （2） Part of risk factors and their risk ratios on breast cancer were changing, especially occupation contact, high-fat diet and brassiere wearing when sleeping which were much closer related with breast cancer. Conclusion The occurrence and change of the risk factors on breast cancer were the comprehensive result of biological, psychological, social and behavior factor. Some synthesized measures must be taken in order to control breast cancer effectively.