Chiang Chi-Ting, Hwang Yaw-Huei, Su Che-Chun, Tsai Kuo-Yang, Lian Ie-Bin, Yuan Tzu-Hsuen, Chang Tsun-Kuo
Department of Bioenvironmental Systems Engineering, National Taiwan University, 1 Sec 4. Roosevelt Road, Taipei City, Taiwan.
Geospat Health. 2010 May;4(2):230-42. doi: 10.4081/gh.2010.203.
This study aimed to elucidate whether or not high-risk clusters of oral cancer (OC) incidence spatially correlate with the prevalence rates of betel quid chewing (BQC) and cigarette smoking (CS) in Taiwan. The spatial autocorrelation and potential clusters of OC incidence among the 307 townships and heavy metal content of soil throughout Taiwan were identified using the Anselin's local Moran test. Additionally, the spatial correlations among the incidence of OC, the prevalence of BQC and CS and heavy metal content of soil were determined based on a comparison of spatial clusters. High-risk OC (Moran's I = 0.638, P <0.001) clusters were located in central and eastern Taiwan, while "hot spots" of BQC and CS prevalence were located mainly in eastern Taiwan. The distributions of BQC and CS lifestyle factors (P <0.001) were spatially autocorrelated. The "hot spots" of OC largely coincided with the "hot spots" of BQC, except for the Changhua and Yunlin counties, which are located in central Taiwan. However, high soil contents of nickel and chromium (P <0.001) in central Taiwan also coincided with the high-risk areas of OC incidence. In particular, Changhua county has incurred several decades of serious heavy-metal pollution, with inhabitants living in polluted areas having high-risk exposure to these metals. Results of this study suggest that, in addition to BQC and CS, anthropogenic pollution may profoundly impact the complexity of OC aetiology in central Taiwan.
本研究旨在阐明台湾口腔癌（OC）高风险发病集群在空间上是否与嚼食槟榔（BQC）和吸烟（CS）的流行率相关。利用安塞林局部莫兰检验确定了台湾307个乡镇中OC发病率的空间自相关性和潜在集群以及全台湾土壤中的重金属含量。此外，基于空间集群的比较，确定了OC发病率、BQC和CS流行率以及土壤重金属含量之间的空间相关性。高风险OC集群（莫兰指数I = 0.638，P <0.001）位于台湾中部和东部，而BQC和CS流行的“热点”主要位于台湾东部。BQC和CS生活方式因素的分布（P <0.001）存在空间自相关性。除了位于台湾中部的彰化县和云林县外，OC的“热点”与BQC的“热点”在很大程度上重合。然而，台湾中部土壤中镍和铬的高含量（P <0.001）也与OC发病的高风险区域重合。特别是，彰化县遭受了数十年的严重重金属污染，生活在污染地区的居民面临这些金属的高风险暴露。本研究结果表明，除了BQC和CS外，人为污染可能对台湾中部OC病因的复杂性产生深远影响。
