Yatsuya Hiroshi, Toyoshima Hideaki, Mizoue Tetsuya, Kondo Takaaki, Tamakoshi Koji, Hori Yoko, Tokui Noritaka, Hoshiyama Yoshiharu, Kikuchi Shogo, Sakata Kiyomi, Hayakawa Norihiko, Tamakoshi Akiko, Ohno Yoshiyuki, Yoshimura Takesumi
Department of Public Health/ Health Information Dynamics, Field of Social Life Science, Program in Health and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Int J Cancer. 2002 Feb 10;97(5):688-94. doi: 10.1002/ijc.10101.
Familial aggregation of stomach cancer has long been observed. The effect on disease risk of family history and its magnitude according to the type of affected relatives, however, is not well known. We conducted a prospective analysis using the JACC study (Japan Collaborative Cohort Study For Evaluation of Cancer Risk, sponsored by Monbusho) data. During the follow-up period, 662 stomach cancer deaths were documented. A positive history of stomach cancer in one or more first-degree relatives was associated with a significantly increased risk of death from the disease in both men (RR 1.60; 95% CI 1.11-2.31) and women (RR 2.47; 95% CI 1.50-4.06). In the subanalysis stratified by age, the association between positive family history and stomach cancer was stronger in the age group from 40-59 (RR 2.62; 95% CI 1.34-5.11 for men and RR 5.88; 95% CI 2.70-12.82 for women) than in the age group from 60-79 (RR 1.31; 95% CI 0.84-2.05 for men and RR 1.44; 95% CI 0.72-2.88 for women). In the age group from 40-59, men with father's history and women with mother's and sister's history of the disease had a significantly increased risk (RR 3.14; 95% CI 1.51-6.55, RR 10.46; 95% CI 4.54-24.12, RR 13.39; 95% CI 3.89-46.12, respectively). When 2 or more family members were affected, the increment in the risk was prominent especially in women (RR 9.45; 95% CI 4.46-20.05). These results suggest the existence of a certain subtype of stomach cancer that is inherited more often by women from one generation to the next in gender-influenced fashion. Any preventive strategy should take into account the degree of individual susceptibility.
胃癌的家族聚集现象早已被观察到。然而，家族史对疾病风险的影响及其根据受影响亲属类型的程度尚不清楚。我们使用JACC研究（由文部省赞助的日本癌症风险评估协作队列研究）数据进行了一项前瞻性分析。在随访期间，记录了662例胃癌死亡病例。一个或多个一级亲属有胃癌阳性病史与男性（RR 1.60；95% CI 1.11 - 2.31）和女性（RR 2.47；95% CI 1.50 - 4.06）因该疾病死亡的风险显著增加相关。在按年龄分层的亚分析中，40 - 59岁年龄组中家族史阳性与胃癌之间的关联比60 - 79岁年龄组更强（男性RR 2.62；95% CI 1.34 - 5.11，女性RR 5.88；95% CI 2.70 - 12.82），而60 - 79岁年龄组中男性为RR 1.31；95% CI 0.84 - 2.05，女性为RR 1.44；95% CI 0.72 - 2.88。在40 - 59岁年龄组中，有父亲胃癌病史的男性以及有母亲和姐妹胃癌病史的女性风险显著增加（分别为RR 3.14；95% CI 1.51 - 6.55，RR 10.46；95% CI 4.54 - 24.12，RR 13.39；95% CI 3.89 - 46.12）。当两个或更多家庭成员受影响时，风险增加尤为显著，尤其是女性（RR 9.45；95% CI 4.46 - 20.05）。这些结果表明存在某种亚型的胃癌，女性以性别影响的方式在代际间更易遗传。任何预防策略都应考虑个体易感性程度。
