北京地区子宫内膜癌发病相关因素的探讨

Epidemiological study of endometrial cancer in Beijing

目的：了解北京地区子宫内膜癌发病情况及相关因素，从而为采取有针对性的预防措施提供客观、科学的决策依据。方法：病例对照方法。以2001—01-01-2002-12-31北京市居民中l临床首次确诊尚存活并追访到的子宫内膜癌患者421例作为病例组，按1：3比例取年龄相差4岁以内、居住在同一个社区者匹配1263名女性作为对照组。结果：内膜癌患者发病年龄22～84岁，平均年龄56．83岁。绝经后发病者占60．8％。单因素卡方检验显示，内膜癌的发生与以下因素有关：职业、收入、被动吸烟、戒烟年限、饮酒、体质量指数、月经生育、避孕、激素替代及使用他莫西芬情况、高血压、糖尿病、甲亢、不孕症、子宫内膜异位症、一侧卵巢切除、一二级亲属中有人患子宫癌或卵巢癌。结论：内膜癌的发病率在北京市呈稳定而缓慢的上升趋势，城区高于郊县，但是发病率仍≤10／10万。月经初潮早、不孕、肥胖、高血压、糖尿病、激素替代治疗、使用他莫西芬及内膜癌家族史，这些因紊为内膜癌的高危因素。

OBJECTIVE： To explore risk factors of endometrial cancer in Beijing, and finally find out evidence upon which decisions can be made for preventive activities. METHODS： Case control stud- y. Eligible case patients （n=421） were Beijing residents who were for the first time diagnosed of endometrial carcinoma from Jan. 1 2001 to Dec. 31 2002, and who were still accessible in the mean time. Each case was compared to 3 controls matched on age and resi dence. RESULTS：The age of the patients ranged from 22 to 84 with the mean of 56.83. A total of 60.8% of the patients were postm- enopausal at diagnoses. Univariate analyses by Chi-square tests found the following parameters which had a statistically significant association with endometrial cancer： occupation, income, passive smoking, alcohol consumption, body mass index （BMI）, menstru al, and reproductive status, contraception, Hormone replace thera py （HRT） and tamoxifen use, hypertension, diabetes mellitus, in- fertility, endometriosis, removal of unilateral ovary, family history of endometrial cancer and ovarian cancer. CONCLUSIONS： Endome trial cancer incidence in Beijing has a slow but steady rise. The inci- dence in urban areas is nearly twice as high as that of the suburbs. The following parameters are found to be independent risk factors of endometrial cancer：early age at menarche, obesity, diabetes, family history of endometrial cancer.