Yang Hsiao-Yu, Wang Jung-Der, Lo Tsai-Chang, Chen Pau-Chung
Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
J Epidemiol. 2009;19(1):17-23. doi: 10.2188/jea.je20080035. Epub 2009 Jan 22.
A national survey in Taiwan has shown that Chinese herbal therapy increases the risk of chronic kidney disease. However, it is unknown whether herbal therapy will increase the risk of urological cancers. The purpose of this study was to determine whether Chinese herbalists are at higher risk for urological cancers.
We studied all Chinese herbalists in Taiwan that were registered in the Chinese Herbalist Labor Union between 1985 and 2000. We retrospectively followed their survival status and causes of death using the National Mortality Registry Database from 1985 to 2004. Standardized mortality ratios (SMRs) for urological cancers in herbalists were calculated and compared with those of the general population of Taiwan.
A total of 6548 Chinese herbalists were enrolled and 88,289 person-years were accrued during the observation period. After adjustment for age and sex, the SMR for urological cancers was significantly higher for Chinese herbalists than for the general population (SMR = 3.10; 95% CI: 1.41-5.87). When further stratified by location, the SMR for kidney cancer and other urinary organ cancers (SMR = 3.81; 95% CI: 1.39-8.28) except bladder cancer (SMR = 2.26; 95% CI: 0.47-6.59) were significantly higher for the Chinese herbalists. The SMR for chronic and unspecified nephritis, renal failure, and renal sclerosis were also significantly higher for herbalists (SMR = 2.40; 95% CI: 1.40-3.84).
Chinese herbalists have a significantly higher risk for urological cancers. This increased risk among herbalists highlights the urgent need for safety assessments of Chinese herbs.
台湾的一项全国性调查显示,中草药疗法会增加慢性肾病的风险。然而,尚不清楚草药疗法是否会增加泌尿系统癌症的风险。本研究的目的是确定中医师患泌尿系统癌症的风险是否更高。
我们研究了1985年至2000年期间在中医师工会注册的台湾所有中医师。我们使用1985年至2004年的国家死亡率登记数据库回顾性地跟踪他们的生存状况和死亡原因。计算中医师泌尿系统癌症的标准化死亡率(SMR),并与台湾普通人群的进行比较。
共纳入6548名中医师,观察期内累积人年数为88289人年。在调整年龄和性别后,中医师泌尿系统癌症的SMR显著高于普通人群(SMR = 3.10;95% CI:1.41 - 5.87)。按地点进一步分层时,除膀胱癌(SMR = 2.26;95% CI:0.47 - 6.59)外,中医师肾癌和其他泌尿器官癌症的SMR(SMR = 3.81;95% CI:1.39 - 8.28)显著更高。中医师慢性和未特定的肾炎、肾衰竭及肾硬化的SMR也显著更高(SMR = 2.40;95% CI:1.40 - 3.84)。
中医师患泌尿系统癌症的风险显著更高。中医师中这种增加的风险凸显了对中草药进行安全性评估的迫切需求。