Bosetti Cristina, Pira Enrico, La Vecchia Carlo
Istituto di Ricerche Farmacologiche Mario Negri, via Eritrea, 62-20157, Milan, Italy.
Cancer Causes Control. 2005 Nov;16(9):997-1008. doi: 10.1007/s10552-005-3636-5.
Epidemiological studies on the potential association between painting and the risk of bladder cancer published after the Monograph of the International Agency for Research on Cancer N. 47 of 1989 have been systematically reviewed. These included four cohort studies on the incidence of bladder cancer among painters, with a pooled relative risk (RR) of 1.10 (95% confidence interval, CI, 1.03-1.18), based on 893 cases observed. The corresponding summary RR from four cohort studies on mortality was 1.23 (95% CI 1.11-1.37), based on 370 deaths. The pooled RR from 14 case-control studies and a pooled-analysis of other 11 case-control studies was 1.35 (95% CI 1.19-1.53), based on 465 cases exposed. Overall, the RR from all epidemiological studies was 1.17 (95% 1.11-1.27). Thus, recent epidemiological evidence indicates a moderate excess risk for bladder cancer in painters. Some studies, however, suggested that any such risk would have been greater for exposures in the distant past. Open issues for interpretation include residual confounding by social class and tobacco smoking, and understanding the time-risk relation. In particular, the potential residual risk related to exposure over the last two to three decades remains to be defined.
对1989年国际癌症研究机构第47号专论之后发表的关于绘画与膀胱癌风险之间潜在关联的流行病学研究进行了系统综述。这些研究包括四项关于画家膀胱癌发病率的队列研究，基于观察到的893例病例，合并相对风险（RR）为1.10（95%置信区间，CI，1.03 - 1.18）。四项关于死亡率的队列研究的相应汇总RR为1.23（95% CI 1.11 - 1.37），基于370例死亡病例。14项病例对照研究以及另外11项病例对照研究的汇总分析得出的汇总RR为1.35（95% CI 1.19 - 1.53），基于465例暴露病例。总体而言，所有流行病学研究的RR为1.17（95% 1.11 - 1.27）。因此，近期的流行病学证据表明画家患膀胱癌存在中度额外风险。然而，一些研究表明，过去长期暴露的此类风险可能更大。有待解释的开放性问题包括社会阶层和吸烟造成的残余混杂因素，以及对时间 - 风险关系的理解。特别是，过去二三十年暴露相关的潜在残余风险仍有待确定。
