山东省上消化道癌危险因素的病例对照研究

Risk factors of upper gastrointestinal cancer in Shandong Province:a case-control study

目的了解居民饮食及生活行为方式对山东省上消化道癌发病的影响,为进一步完善癌症防治策略提供参考依据。方法根据经济发展水平,在山东省东、中、西部分别选择2个县(市、区)进行问卷调查。从各县(市、区)医院调查的上消化道癌患者中选取病例组;在同县(市、区)选取2~3个村或社区进行居民调查,从中选取对照组。按照病例与对照1:1配对设计进行居民饮食及生活行为方式对上消化道癌发病影响的条件logistic回归分析。结果病例组和对照组共匹配379对,包括224对男性和155对女性,病例组和对照组平均年龄分别为(67.71±8.58)和(67.67±8.65)岁,有上消化道疾病史、吸烟、饮酒、热烫饮食、新鲜水果5个因素进入多因素分析。多因素logistic回归分析显示,上消化道疾病史、饮酒、热烫饮食为上消化道癌的危险因素,OR值分别为2.609(1.805~3.773)、1.586(1.009~2.492)和1.466(1.020~2.108),新鲜水果是上消化道癌的保护因素,OR值为0.603(0.434~0.837)。结论在今后的工作中应进一步提高全社会癌症防控意识,加强对上消化道癌主要危险因素的健康宣教,强调早期筛查的重要性,以降低上消化道癌的发病风险。

Objective To find out the influence of the residents'diet and lifestyle on the incidence of upper gastrointestinal cancer in Shandong Province,and to provide a reference for further improvement of cancer prevention and treatment strategies.Methods We selected two counties(cities,districts)in the eastern,central and western parts of Shandong Province to conduct a questionnaire survey respectively.The case group was selected from the upper gastrointestinal cancer patients surveyed by hospitals in various counties(cities,districts).The control group was selected from a resident survey conducted in 2or 3villages or communities in the same county(city,district).Conditional logistic regression analysis of the effect of residents'diet and lifestyle on the incidence of upper gastrointestinal cancer was carried out according to the case-control 1:1pairing design.Results A total of 379pairs of case-control were matched,including 224pairs of males and 155pairs of females.The average age of the case group was(67.71±8.58),and the average age of the control group was(67.67±8.65).Five factors including history of upper gastrointestinal disease,smoking,drinking hot soup and intake of fresh fruit were included in the multivariate analysis.In multivariate conditional logistic analysis,history of upper gastrointestinal disease,alcohol consumption,and hot soup and food were risk factors for upper gastrointestinal cancer,with ORs of 2.609(1.805-3.773),1.586(1.009-2.492)and 1.466(1.020-2.108),respectively.Fresh fruit was a protective factor for upper gastrointestinal cancer with an ORof 0.603(0.434-0.837).Conclusion In the future work,health education on major risk factors should be strengthened,and the importance of early screening should be emphasized to reduce the risk of upper gastrointestinal cancer.