Cheng K K, Day N E, Duffy S W, Lam T H, Fok M, Wong J
Department of Community Medicine, University of Hong Kong.
Lancet. 1992 May 30;339(8805):1314-8. doi: 10.1016/0140-6736(92)91960-g.
Oesophageal cancer is common in Chinese populations, but individual-based epidemiological studies have provided little explanation. A case control study with 400 cases and 1598 controls (800 hospital and 798 general practice) was conducted among Hong Kong Chinese. In multivariate analyses, statistically significant effects on risk were detected for several potentially preventable exposures with high attributable risks (ARs). These included preference for consuming drinks or soups at high temperature (AR = 14%), infrequent consumption of green leafy vegetables (AR = 15%) and citrus fruits (AR = 26%), ingestion of pickled vegetables (AR = 29%), tobacco smoking (AR = 44%), and alcohol drinking (AR = 48%). On the assumption of multiplicative risk, the combined AR due to these exposures was 89%. This is the first case control study to show an association between pickled vegetable consumption and oesophageal cancer risk. The finding considerably strengthens the evidence for carcinogenicity of N-nitroso compounds in man and helps to explain the very high risk among Chinese.
食管癌在中国人群中很常见，但基于个体的流行病学研究对此解释甚少。在香港华人中开展了一项病例对照研究，共纳入400例病例和1598名对照（800名来自医院，798名来自普通诊所）。在多变量分析中，检测到几种具有高归因风险（AR）的潜在可预防暴露因素对风险有统计学显著影响。这些因素包括偏好饮用高温饮品或汤类（AR = 14%）、很少食用绿叶蔬菜（AR = 15%）和柑橘类水果（AR = 26%）、食用腌制蔬菜（AR = 29%）、吸烟（AR = 44%）以及饮酒（AR = 48%）。基于风险相乘的假设，这些暴露因素导致的综合归因风险为89%。这是第一项表明食用腌制蔬菜与食管癌风险之间存在关联的病例对照研究。该发现大大加强了N-亚硝基化合物对人类致癌性的证据，并有助于解释中国人中极高的食管癌风险。
