吸烟与中国人膀胱癌相关性的多中心病例对照研究

Multicenter case-control study of the relationship between smoking and bladder cancer in China

目的调查吸烟与中国人膀胱癌发病的相关性。方法2005年9月至2008年6月期间运用多中心病例对照研究调查432例膀胱癌患者和392例对照者（非泌尿系统恶性肿瘤患者），通过问卷调查的方式对吸烟方式、开始吸烟年龄、戒烟时间、吸烟量、烟雾吸人深度等项目进行调查，评估所有关联因素导致膀胱癌发生的危险性及所对应的95％可信区间。结果主动、被动吸烟者均会增加膀胱癌的危险性（P〈0．05），现吸烟组的比例高于对照组（40．7％和28．1％），与非吸烟者相比主动吸烟的膀胱癌危险相关性增加1．89倍。吸烟数量增加与膀胱癌发生的风险具有明显相关性（P〈0．05），膀胱癌发生的危险性随着烟龄的延长而增加（P〈0．05），但与最初开始吸烟的年龄无关（P〉0．05），而将烟雾吸人口或喉会明显增加膀胱癌的危险性（P〈0．05）。结论吸烟是中国人膀胱癌的明显致病因素，且主／被动吸烟、烟龄、吸烟的数量及烟雾吸人位置均与膀胱癌的发生具有明显相关性，不吸烟是预防膀胱癌发生最好的方式。

Objective To explore the relationship between smoking and bladder cancer in China. Methods A multicenter case-control study was conducted from September 2005 to June 2008. A total of 432 bladder cancer patients, matched with 392 control cases, received a questionnaire including the type of exposure （ active vs. passive smoking）, the age of beginning and/or quitting smoking, smoking amount and time and depth of smoke inhalation. Results Both active smoking and passive smoking increased the incidence of bladder cancer （P 〈 0. 05 ）. Bladder cancer risk increased 1.89 times in active smokers and 1.88 times in passive smokers compared to non-smokers （P 〈 0. 05）. Smoke amount and time were significantly correlated with bladder cancer risk（P 〈0. 05）. But the age of beginning smoking did not affect the bladder cancer risk （P 〉 0. 05 ）. Inhaling smoke into mouth or throat was also a risk factor for bladder cancer （ P 〈 0. 05 ）. Conclusion There is a strong association between smoking and bladder cancer. Active and passive smoking, smoke amount and time, and the depth of smoke inhalation are risk factors for bladder cancer. The best way of preventing bladder cancer is never smoking.