Jedrychowski W
Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Cracow, Poland.
J Physiol Pharmacol. 2003 Dec;54 Suppl 3:245-61.
Descriptive epidemiologic studies on the geographical distribution of gastrointestinal diseases in Poland have been conducted in our country since several decades. One of the first descriptive analyses was cancer study in 1967, where age-standardized mortality rates in various regions of Poland by gender and area of residence (urban/rural) were presented. Since 1970 analytical epidemiologic studies aiming at explaining the natural course of various diseases within gastrointestinal tract started to produce interesting results. The first study in this field was the case-control study on the occurrence of peptic ulcer and tobacco smoking performed in 1974. The study provided one of the first epidemiologic evidence on the harmful effect of tobacco smoking in the etiology or peptic ulcers. Subsequent studies dealt with the importance of dietary habits and life style (tobacco smoking and vodka drinking) in the occurrence of gastric cancer. The studies confirmed previous findings that consumption of raw vegetables and fresh fruit is inversely related to risk for stomach cancer in Poland. In addition the results demonstrated, that dietary practices such as the modality of cooking the food, preparation of food products and storing conditions were connected with stomach cancer risk. These factors have also been found to influence the risk for stomach cancer in Poland. The main message of this latter study was that the family as a whole is affected by many risk factors for stomach cancer and families in which stomach cancer has occurred should be therefore targets for preventive measures. Interestingly, analysis of life style factors such as tobacco smoking or vodka drinking has showed that the risk for cardia cancer increased considerably for smokers of cigarettes without filters and in those who consumed large amounts of vodka. For the non-cardia region a uniform increase of risk could be observed for vodka drinking, regardless of cigarette smoking status. The findings of this study suggested the hypothesis that the effect of tobacco smoking and vodka drinking may be different for cardia cancer compared to the distal cancers. Our clinico-epidemiological study suggest that infection with Helicobacter pylori is not sufficient factor for inducing precancer changes in gastric mucosa. Besides, case-controls studies on dietary habits and physical activity level in the etiology of colorectal cancer are in progress. The preliminary results demonstrated the protective effect of higher physical activity in the occurrence of colorectal cancer after accounting for nutritional habits.
几十年来，我国一直在开展关于波兰胃肠道疾病地理分布的描述性流行病学研究。最早的描述性分析之一是1967年的癌症研究，该研究呈现了波兰不同地区按性别和居住区域（城市/农村）划分的年龄标准化死亡率。自1970年起，旨在解释胃肠道各种疾病自然病程的分析性流行病学研究开始产生有趣的结果。该领域的第一项研究是1974年进行的关于消化性溃疡与吸烟的病例对照研究。这项研究提供了吸烟在消化性溃疡病因中有害作用的首批流行病学证据之一。随后的研究探讨了饮食习惯和生活方式（吸烟和饮用伏特加）在胃癌发生中的重要性。这些研究证实了先前的发现，即食用生蔬菜和新鲜水果与波兰胃癌风险呈负相关。此外，研究结果表明，烹饪方式、食品加工和储存条件等饮食习惯与胃癌风险相关。这些因素也被发现会影响波兰的胃癌风险。后一项研究的主要信息是，整个家庭都受到许多胃癌风险因素的影响，因此发生胃癌的家庭应成为预防措施的目标。有趣的是，对吸烟或饮用伏特加等生活方式因素的分析表明，无过滤嘴香烟吸烟者和大量饮用伏特加者患贲门癌的风险大幅增加。对于非贲门区域，无论吸烟状况如何，饮用伏特加都会使风险均匀增加。这项研究的结果提出了一个假设，即与远端癌症相比，吸烟和饮用伏特加对贲门癌的影响可能不同。我们的临床流行病学研究表明，幽门螺杆菌感染并非诱发胃黏膜癌前病变的充分因素。此外，关于饮食习惯和身体活动水平在结直肠癌病因中的病例对照研究正在进行中。初步结果表明，在考虑营养习惯后，较高的身体活动对结直肠癌的发生具有保护作用。
