基于Rothman-Keller法的个体肺癌发病风险评估研究

Personal Lung Cancer Risk Assessment with the Rothman-Keller Method

背景预防肺癌发病是减轻我国肺癌负担的途径之一,加强肺癌的一级预防工作及探索预防新途径尤为重要。疾病风险评估可根据个体情况预测发病风险,通过个性化健康教育指导其生活行为,降低发病风险,在社区卫生和健康管理领域应用广泛,是预防慢性病的重要手段之一。目的建立适用于我国人群的肺癌发病风险评估模型,了解个体肺癌发病绝对风险和相对风险。方法于2017年10月—2018年3月收集整理国内外发表的我国人群肺癌流行病学研究,检索时间为建库至2018-03-31。通过文献评阅明确肺癌主要危险因素及其与肺癌发病风险的定量关系,构建基于Rothman-Keller法的风险预测模型。结果纳入模型主要因素有12个,包括吸烟、被动吸烟、所在地区年平均PM2.5、职业暴露(石棉、粉尘)、肺部疾病史(慢性支气管炎、肺气肿、肺结核)、BMI、新鲜蔬菜食用情况、烹调油烟,根据本研究建立的风险预测模型可评估个体肺癌发病相对风险和未来5年发病风险。结论该模型可用于肺癌的一级预防,间接促进人们养成良好生活方式。

Background Lung cancer prevention is one of the ways to reduce the burden of lung cancer in China.It is particularly important to strengthen the primary prevention of lung cancer and to explore new ways of prevention.Disease risk assessment can reduce the risk of disease by assessing disease risk,and guiding daily life behaviors via health education based on personal conditions.It is widely used in community health and health management as an important way to prevent chronic diseases.Objective To establish a risk assessment model to predict the absolute and relative risks of lung cancer in Chinese population.Methods We collected and reviewed the epidemiological studies of lung cancer in Chinese population from October 2017 to March 2018.The search time was from the establishment of the database to March 31,2018.After this,we determined the major risks for lung cancer and quantified their degrees of association with lung cancer,and used them to construct a lung cancer risk assessment model with the Rothman-Keller method.Results A total of 12 factors were included in the model,including active smoking,passive smoking,average annual PM2.5 in the region,occupational exposure(asbestos,dust),history of pulmonary diseases(chronic bronchitis,emphysema,tuberculosis),BMI,fresh vegetables consumption,cooking fume and other environmental factors.And the model was proved to be effective in predicting personal relative risk of lung cancer and 5-year risk of lung cancer.Conclusion This model can be used for primary prevention of lung cancer,indirectly promoting people to develop a good lifestyle.