城市居民肺癌危险因素的定量评价标准

QUANTITATIVE ASSESSMENT OF THE RISKS OF LUNG CANCER FOR URBAN RESIDENTS.

目的 :制定肺癌危险因素的定量评价标准 ,以便更好地预测个体所处的危险因素对其患肺癌的危险。方法 :通过文献检索收集肺癌危险因素的病例对照和队列研究资料及各种危险因素的暴露率资料 ,收集四川省城市疾病监测点的人口学、疾病死亡及行为危险因素监测资料 ,运用 Meta分析软件对效应量 OR值 (比值比 )进行合并 ,选择统计模型计算肺癌的危险分数 ,根据 Reed- Merrill公式将各性别 /年龄组的死亡率转换成死亡概率 ,用寿命表的方法将全死因及肺癌的 1年死亡概率转换成 10年死亡概率 ,再根据肺癌的危险分数及 10年死亡概率计算肺癌的存在死亡危险。结果 :建立了肺癌的危险分数转换表及肺癌的 10年死亡概率表 ,根据个体所处的危险因素利用危险分数转换表及肺癌的 10年死亡概率计算得到的存在死亡危险 ,可预测个体未来 10年发生肺癌死亡的可能危险 ,并有力地说服个体改变不良的行为生活方式 ,消除或降低所处的危险因素 ,提高健康水平。结论 :该方法是健康教育的有力依据 。

Objective:To determine the risk ratios of the main risk factors of lung cancers so that the potential risks of a particular individual dying from the lung cancers can be quantitatively identified; and ultimately, to facilitate the health education in the communities and to provide lessons for the control of other chronic conditions.Methods:We collected all of the case control and cohort studies about the risk factors of lung cancers in the recent 20 years in China and calculated the overall risk ratio of each risk factor through meta analysis. Then, the demographic data and death rates of lung cancers were used to generate one year death probability by sex and age according to Reed Merrill formula. The one year death probability was later turned into ten year death probability using life tables. Finally, the risk of each individual dying from lung cancers could be estimated based on the above data and the degree of each risk factor for this particular individual.Results:The risk score conversion table and the ten year death probability table for lung cancers were developed.Conclusions:Using the risk score conversion table and the ten year death probability table, we can estimate an individual's risk of dying from lung cancers in the future 10 years and persuade this individual to change certain particular lifestyle and behaviors. This could be a very useful approach in health education and community health services.