Gołkowski Filip, Szybiński Zbigniew, Rachtan Jadwiga, Sokołowski Andrzej, Buziak-Bereza Monika, Trofimiuk Małgorzata, Hubalewska-Dydejczyk Alicja, Przybylik-Mazurek Elwira, Huszno Bohdan
Dept. of Endocrinology, Jagiellonian University, Collegium Medicum, Faculty of Medicine, Kopernika 17, 31-501, Krakow, Poland.
Eur J Nutr. 2007 Aug;46(5):251-6. doi: 10.1007/s00394-007-0657-8. Epub 2007 May 11.
Poland has one of the highest death rates for stomach cancer in Europe. Moderate iodine deficiency and in consequence high goitre prevalence led to the implementation in 1996 of a very efficient mandatory model of iodine prophylaxis, based on household salt iodisation (30 +/- 10 mg KI/1 kg of salt).
The aim of the study was evaluation of incidence rate of stomach cancer and its possible relation to increased iodine consumption in the years 1992-2004.
Iodine supply and effectiveness of iodine prophylaxis were evaluated on the basis of comparative analysis of goitre prevalence and ioduria in schoolchildren. To allow comparison between time periods with varying population age structures, the incidence rates of stomach cancer were standardized for age, using the "world standard population". The direct standardization method has been applied. For each sex, the time-trend of incidence rates was shown in graphs over the years 1991-2004.
Evident increase in iodine consumption in this period of time was proved by rise in percentage of schoolchildren (6-8 years old) with ioduria above 100 microg/l from 11.4% in 1992-1993 to 52.9.1% in 2003. It was correlated with the decrease in goitre prevalence from 18.8% to 3.2% respectively. The 24-h thyroid uptake of (131)I in investigated population fell from 45.5% in 1986 to 26.8% in 1998. In Krakow the standardized incidence ratio of stomach cancer for men decreased from 19.1 per 100,000 to 15.7 per 100,000, and for women from 8.3 per 100,000 to 5.9 per 100,000 in the years 1992-2004. A significant decline of average rate of decrease was observed in men and women (2.3% and 4.0% per year respectively).
Observed association between improved iodine supply and decrease of incidence of stomach cancer could indicate the protective role against stomach cancer of iodine prophylaxis in iodine deficient areas--further studies are necessary.
波兰是欧洲胃癌死亡率最高的国家之一。碘缺乏程度中等，进而导致甲状腺肿患病率较高，这促使波兰在1996年实施了一项基于家庭食盐碘化（30±10毫克碘化钾/1千克盐）的高效强制性碘预防模式。
本研究旨在评估1992 - 2004年间胃癌发病率及其与碘摄入量增加之间的可能关系。
基于对学龄儿童甲状腺肿患病率和尿碘的比较分析，评估碘供应和碘预防的效果。为了能够比较不同人口年龄结构时期的数据，采用“世界标准人口”对胃癌发病率进行年龄标准化。应用了直接标准化方法。针对每种性别，绘制了1991 - 2004年间发病率随时间变化的趋势图。
这一时期碘摄入量明显增加，表现为尿碘高于100微克/升的6 - 8岁学龄儿童百分比从1992 - 1993年的11.4%上升至2003年的52.9%。这与甲状腺肿患病率分别从18.8%降至3.2%相关。研究人群中24小时甲状腺对（131）I的摄取率从1986年的45.5%降至1998年的26.8%。在克拉科夫，1992 - 2004年间男性胃癌标准化发病率从每10万例19.1例降至每10万例15.7例，女性从每10万例8.3例降至每10万例5.9例。男性和女性的平均下降率均出现显著下降（分别为每年2.3%和4.0%）。
观察到的碘供应改善与胃癌发病率下降之间的关联可能表明，在碘缺乏地区，碘预防对胃癌具有保护作用——仍需进一步研究。
