上海市区饮食与胃癌发病的病例对照研究

Diet and Gastric Cancer:a Case-control Study in Shanghai Urban Districts

背景:近30年来上海市区胃癌发病率已明显下降。1972～1999年,男性和女性胃癌的年龄调整发病率分別从62.0/10万和23.9/10万降至35.8/10万和17.5/10万。目的:研究环境因素,尤其是饮食因素与居住在上海市区15年以上的居民胃癌发病的关系,以探讨近30年来上海市区胃癌发病率逐渐下降的原因。方法:采用统一饮食频度问卷调查189例胃癌患者和567名对照人群,调查内容包括一般情况、胃癌发病前5年和10年的住房和收入状况、饮食和生活习惯、冰箱使用、吸烟和饮酒史、既往胃病史、肿瘤家族史等。采用SPSS软件包进行单因素和多因素非条件Logistic回归分析。结果:常服维生素、使用冰箱储存食物、多食新鲜水果、蔬菜、豆、奶制品和良好的饮食习惯等为预防胃癌的保护因素;肿瘤家族史、慢性胃病史、多食煎炸、盐渍、腌晒、烟熏食品、不良饮食习惯、吸烟、饮白酒等为发生胃癌的危险因素。结论:近30年来上海市区居民胃癌发病率的下降与环境因素,特别是饮食因素和广泛使用冰箱密切相关。

Background: The incidence rates of gastric cancer in Shanghai urban districts have been declining remarkably in recent 3 decades. From 1972 to 1999 the age-adjusted incidence rates of gastric cancer decreased from 62.0/100 000 to 35.8/100 000 in males and from 23.9/100 000 to 17.5/100 000 in females. Aims: To investigate the relationship between the environmental factors, in particular the dietary factors and the development of gastric cancer in those who lived in Shanghai urban districts for more than 15 years, and to explore the causes that led to the reduction of the incidence rates of gastric cancer in Shanghai urban districts. Methods: One hundred and eighty-nine patients with gastric cancer and 567 controls were matched to survey with a questionnaire, which consisted of demography, housing conditions and income 5 and 10 years prior to the onset of gastric cancer, dietary habits, lifestyle, use of home refrigerators, smoking and alcohol drinking, past history of gastric diseases, family history of cancer, etc. SPSS software package was used to perform the univariate and multivariate unconditional Logistic regression analysis model. Results: Supplements of vitamins, use of home refrigerators, high consumption of fresh fruits and vegetables, bean and dairy products, and good eating habits were protective factors against gastric cancer. However, family history of cancer, chronic gastric diseases, increased intake of fried, salted, pickled and smoked foods, and bad eating habits, smoking and alcohol drinking were risk factors for gastric cancer. Conclusions: The reduction of the incidence rates of gastric cancer in Shanghai urban districts in recent 3 decades was closely related to environmental factors, in particular the dietary factors and widely use of home refrigerators.