云南省宣威市肺癌危险因素研究

发布时间：2018-06-05 05:16

本文选题：宣威 + 肺肿瘤　；参考：《中国肺癌杂志》2017年08期

【摘要】：背景与目的自1970年代至今,云南省宣威市始终是我国肺癌高发地区之一,且其女性高发、地区聚集性高发的特征未发生过改变。本研究目的在于进一步关注宣威市普通居民肺癌高发危险因素暴露的变化情况,以预测未来肺癌分布特征。方法根据2010年-2012年肺癌死亡率将宣威市26个乡镇划分为高、中、低发区后,根据地形和方位选取6个乡镇(高中低发区各2个),并从每个乡镇中随机抽取4个行政村作为调查点。对调查点中居民样本人群进行肺癌危险因素面对面调查。计算高、中、低发区人群危险因素暴露率,以及性别、年龄别亚组人群暴露率,其中生活环境方面危险因素计算现在和十年前。采用标化率和标化率比较的统计学检验或卡方检验,比较区域间或两时间点暴露水平的高低。结果研究地区65%-80%的男性有吸烟史,60%-90%的从未吸烟者有二手烟暴露史。烟草使用和二手烟暴露均是在肺癌高、中发区明显严重于低发区。中发区50%的男性有煤矿工作经历,是高、低发区的2倍;而高发区15%-25%的人有其他职业烟尘暴露史,是中、低发区的3倍-5倍。从十年前到现在,中发区都有近80%的家庭每年使用2吨或更多烟煤,有超90%的家庭使用燃煤取暖,有60%多的家庭做饭时厨房油烟多,有60%的家庭日常最常使用有烟囱地炉。高发区目前倒只有20%的家庭大量使用烟煤。整个研究地区50%-75%的家庭每年使用700度或更多电,比十年前用电量大增。低发区80%的人经常吃高油脂或腌制熏制食品,高、中发区为50%-60%。结论从本次调查数据来看,目前烟煤使用情况的分布与肺癌高中低发区的分布已不一致。烟草流行包括二手烟暴露,烟煤使用,职业暴露可能是当前宣威肺癌仍旧高发的原因。炉灶类型、饮食习惯等危险因素与宣威肺癌间的相关性值得进一步研究。
[Abstract]:Background & objective since 1970's, Xuanwei City, Yunnan Province has always been one of the high incidence areas of lung cancer in China, and its female incidence is high, and the characteristics of high incidence of regional aggregation have not changed. The purpose of this study was to study the changes of high risk factors of lung cancer in Xuanwei, and to predict the distribution of lung cancer in the future. Methods according to the mortality rate of lung cancer from 2010 to 2012, 26 townships in Xuanwei were divided into high, middle and low incidence areas. According to the terrain and location, 6 villages were selected (2 in each high school and low incidence area), and 4 administrative villages were randomly selected from each township as investigation points. Face-to-face investigation of lung cancer risk factors was carried out among residents in the survey site. The population exposure rates of high, middle and low risk areas, as well as sex and age subgroups, were calculated now and 10 years ago. Statistical test or chi-square test were used to compare the level of exposure between regions or at two time points. Results 65-80% of the men in the study area had a history of smoking. 60-90% of the men who had never smoked had a history of exposure to secondhand smoke. Tobacco use and secondhand smoke exposure were higher in lung cancer and more serious in middle-onset areas than in low-risk areas. 50% of the men in the middle incidence area had coal mine work experience, which was twice as high as that in the low incidence area, while between 15% and 25% of the men in the high incidence area had a history of exposure to other occupational smoke dust, which was 3 to 5 times higher than that in the middle and low incidence area. From ten years ago to now, nearly 80% of households in the middle developed area use 2 tons or more of bituminous coal annually, over 90% use coal for heating, more than 60% use cooking smoke in the kitchen, and 60% use chimney stoves most often. At present, only 20% of households in high incidence areas use bituminous coal. Between 50 and 75 percent of households in the study area use 700 or more degrees of electricity a year, up from a decade ago. 80% of the people in the low-risk area often ate high fat or pickled smoked food. Conclusion according to the survey data, the distribution of bituminous coal use is not consistent with the distribution of high and low incidence areas of lung cancer. Tobacco epidemics, including secondhand smoke exposure, bituminous coal use, and occupational exposure, may be the cause of the current high incidence of lung cancer in Xuanwei. The correlation between the types of stoves, eating habits and Xuan Wei lung cancer deserves further study.
【作者单位】：中国医学科学院基础医学研究所暨北京协和医学院基础学院;云南省宣威市疾病预防控制中心;
【分类号】：R734.2

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