随访队列的结直肠癌危险因素的病例-对照研究

The case-control study on relationship between environmental risk exposure and incidence of colorectal cancer in the population-based cohort

目的 研究环境暴露因素与结直肠癌发病的联系 ,为采取有效的预防措施提供科学依据。方法 以嘉善结直肠癌筛检队列为研究人群 ,采用单纯随机抽样方法选择正常人对照 343例 ,以及随访至今发生的结直肠癌存活病例 12 6例 ,进行结直肠癌流行病学调查 ,并以非条件logistic回归法分析各因素与结直肠癌发生的关系。 结果 同事吸烟、粘液血便史、服用导泻药史、肠息肉史、乙肝史、家族结直肠癌史和常食动物油是结肠癌的危险因素 ,OR值依次为 :4 .87、2 8.84、13.0 0、7.6 8、6 .98、5 .5 5和 2 .4 1,香蕉 (OR =0 .6 6 )是保护因素 ;粘液血便史 (OR =112 .0 4 ) ,腺瘤史 (OR =31.92 ) ,肠息肉史 (OR =8.0 7) ,腹部手术史 (OR =2 .4 0 ) ,食用炸肉 (OR =12 .88) ,红烧鱼 (OR =1.77) ,均为直肠癌的危险因子 ,常饮深井水 (OR =0 .32 ) ,常吃白菜、蘑菇、西瓜和爱吃白糖能显著降低直肠癌的风险 ,OR依次为 :0 .32、0 .6 0、0 .5 1、0 .6 7和 0 .5 5。结论 同事吸烟、粘液血便史、服用导泻药史、肠息肉史、乙肝史、家族结直肠癌史、和动物油、炸肉、红烧鱼、香蕉、白菜、蘑菇、西瓜等饮食与结直肠癌的发生有一定影响。

Objective To investigate the risk factors and occurrence of colorectal cancer(CRC) in Jiashan county. Methods A case-control study was conducted to containe 343 health controls selected randomly among a CRC-cohort population, and 126 patients. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression models. Results Risk of colon cancer was increased with one of follow factors: passive smoking (colleague), mucoid stool, taking purgation medicine, intestinal polyposis, hepatitis B, family CRC history and animal fat. The OR value were 4.87, 28.84, 13.00, 7.68, 6.98, 5.55 and 2.41, respectively. While decreased with banana (OR=0.66). Mucoid stool (OR=112.04), adenoma(OR=31.92),bowel polyps (OR=8.07),operation on abdominal region (OR=2.40),fried meat(OR=12.88),fish cooked with soybean sauce(OR=1.77) were all risk factors of rectal cancer; while Drinking deep-well water (OR=0.32),Chinese cabbage, mushroom, laver, and white sugar were protective factors,OR value were 0.60,0.51,0.67 and 0.55,respectively.Conclusion Passive smoking, mucoid stool, taking purgation medicine, intestinal polyposis, hepatitis B, family CRC history and animal fat, fried meat, fish cooked with soybean sauce,banana, Chinese cabbage, mushroom, laver have a certain extent affect the occurrence of CRC.