福建省主要消化道肿瘤高低发区甘薯摄入及其他相关因素分析

Analysis on sweet potato and other influential factors of digestive tumor in high and low prevelance areas in Fujian province

目的探讨福建省不同消化道肿瘤高低发区甘薯等饮食摄入与消化道肿瘤的关系。方法按照多阶段分层随机抽样的方法确定福建省5个疾病监测点的调查对象,采用入户调查方式对2 930名调查对象进行问卷调查(含半定量食物频率调查),按各种消化道肿瘤死亡率的平均值为标准,将5个监测点分别划分为胃癌、肠癌、肝癌高低发区,采用多因素logistic回归分析其影响。结果肠癌在老年多发,可能降低两地肠癌发病水平的因素有常吃甘薯、采用蒸或煮方式烹调、甘薯摄入量在主食中占比较大、每日甘薯摄入量多(近1年和10年前)、饮用自来水或桶装水等;可能升高两地肠癌发病水平的因素有粮谷类摄入量大以及水产品摄入量过多。胃癌在中老年多发,可能影响两地胃癌发病水平的因素有甘薯摄入量在主食中占比较大、每日甘薯摄入量多(10年前)。肝癌在青壮年高发,之后随着年龄的增长呈下降趋势,可能影响两地肝癌发病水平的因素有饮用红茶或龙井茶、自来水或桶装水、饮茶频率、水产品摄入等。结论中青年是预防肝癌的重点人群,中老年是预防胃癌的重点人群老年人是预防肠癌的重点人群;鼓励多采用蒸、煮烹调方式;增加膳食纤维摄入量对胃、肠癌的预防有积极作用;饮用清洁水源、适当饮茶等对肠癌、肝癌预防有积极作用。

Objective To investigate the sweet potato intake and other influence factors in relation to digestive cancer in Fujian province. Methods A total of 2 930 subjects were selected using multi-stage stratified random sampling method and were interviewed in person. Five survey areas were divided into two types(high or low incidence area) for intestinal, gastric and liver cancer, respectively. Data were analyzed by using conditional logistic regression. Results Intestinal cancer had higher prevalence in the elderly population; liver cancer had higher prevalence in young adults; gastric cancer had higher prevalence in middle-aged people. Increased risk of intestinal cancer was associated with adequate intakes of grain and aquatic produce while decreased risk of colorectal cancer was associated with frequent consumption of sweet potato, higher ratio of sweet potato in staple food, steaming or stewing, cleaning water sources. Influence risk of gastric cancer was associated with frequent consumption of sweet potato, higher ratio of sweet potato in staple food. Influence risk of liver cancer was associated with drinking black tea or oolong tea, cleaning water sources and aquatic produce. Conclusion Young adults are a primary target population for liver cancer prevention, while elderly population is a primary target for intestinal cancer prevention. It should be encouraged to use steaming and boiling cooking methods and intake sufficient dietary fibers to prevent from gastric and intestinal cancers. The results also encourage drinking from clean water sources and suitable amount of tea to protect against intestinal and liver cancers.