阳江高本底地区居民鼻咽癌危险因素的巢式病例对照研究

Nested Case-control Study on the Risk of Nasopharyngeal Carcinoma in the High Background Radiation Areas of Yangjiang,China.

目的 探讨阳江高本底辐射地区居民鼻咽癌的主要危险因素。方法 应用巢式病例对照研究方法 ,对一个 10万余人队列随访了 9a ,队列中 3 0及 3 0岁以上鼻咽癌死亡病例 98例作为病例组。对有关暴露因素进行单因素分析和多因素非条件logistic回归分析。结果 文化程度、吃咸鱼、慢性鼻炎史和家族鼻咽癌史是鼻咽癌独立的危险因素 ;吸烟、饮酒与鼻咽癌的发病无明显关联 ;高本底辐射与鼻咽癌发病的关系 ,在经上述四个因素校正前、后 ,其OR值分别为 0 86和 0 87,差异无显著性 ;剂量—效应关系结果表明 ,最高剂量组的OR值有轻微降低 ,但差异无显著性。结论 经常进食咸鱼是鼻咽癌发病的一个重要因素 ;文化程度、慢性鼻炎史和家族鼻咽癌史与鼻咽癌发病也存在相关性 ;

Objective To identify the major determinants of nasopharyngeal carcinoma(NPC) in the high-background radiation areas(HBRA)in Yangjiang,China.Methods A nested case-control study was conducted based on 106517 subjects.98 cases that died of NPC were detected during a follow-up program for 9 years.Univariate analysis and multivarate non-conditional logistic regression were used to analyze associations between the exposure factors and NPC.Results Multivariate conditional logistic regression analysis revealed that education levels,salted fish intake,the history of chronic rhinitis and the family history of NPC were independent risk factors of NPC.Tobacco smoking and alcohol consumption were not significantly related to NPC risk.The ORs of NPC risk comparing HBRA and a nearby control area before and after adjustment for the major risk determinants identified in the present study was 0.86 and 0.87,respectively.Conclusion Salted fish intake was a strong risk factor of NPC.Education,the history of chronic rhinitis and the family history of NPC were also related to NPC risk.The exposure to high background radiation in HBRA of Yangjiang was not related to NPC risk with or without the adjustment for those major risk determinants of NPC.