Michaud D S, Clinton S K, Rimm E B, Willett W C, Giovannucci E
Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
Epidemiology. 2001 Nov;12(6):719-26. doi: 10.1097/00001648-200111000-00022.
Large regional variations in bladder cancer rates have been observed for numerous decades in the United States and persist to date. We examined the incidence rates of bladder cancer by geographic region among U.S. male health professionals to determine whether diet or other lifestyle factors can account for variations observed. During 12 years of follow-up, 328 cases of bladder cancer were diagnosed in the Health Professionals Follow-up Study cohort. We inquired about diet, lifetime history of smoking, race, marital status, and other nondietary factors using mailed questionnaires. An elevated risk of bladder cancer was observed in the Northeast compared with the West [relative risk (RR) = 1.71, 95% confidence interval (CI) = 1.23-2.39], which was slightly attenuated after controlling for smoking (RR = 1.65, 95% CI = 1.18-2.30). Smoking patterns, diet, and other lifestyle factors could not account for all of the elevated bladder cancer risk in the Northeast. Bladder cancer risk was highest among men who had a long residency in the Northeast compared with a long residency in the West (RR = 1.77, 95% CI = 1.15-2.71, adjusted for smoking). Diet and other known characteristics do not appear to be responsible for the regional variations in bladder cancer rates in the United States.
在美国，数十年来一直观察到膀胱癌发病率存在很大的地区差异，且这种差异至今仍然存在。我们研究了美国男性健康专业人员中按地理区域划分的膀胱癌发病率，以确定饮食或其他生活方式因素是否能够解释所观察到的差异。在12年的随访期间，健康专业人员随访研究队列中诊断出328例膀胱癌病例。我们通过邮寄问卷询问了饮食、吸烟史、种族、婚姻状况和其他非饮食因素。与西部相比，东北部观察到膀胱癌风险升高[相对风险（RR）=1.71，95%置信区间（CI）=1.23-2.39]，在控制吸烟因素后略有减弱（RR = 1.65，95% CI = 1.18-2.30）。吸烟模式、饮食和其他生活方式因素无法解释东北部所有升高的膀胱癌风险。与长期居住在西部的男性相比，长期居住在东北部的男性患膀胱癌的风险最高（RR = 1.77，95% CI = 1.15-2.71，经吸烟因素调整）。饮食和其他已知特征似乎并非美国膀胱癌发病率地区差异的原因。
