Chen Wan-qing, He Yu-tong, Sun Xi-bin, Wen Deng-gui, Chen Zhi-feng, Zhao De-li
Cancer Hospital & Institute, Chinese Academy of Medical Sciences, National Office for Cancer Prevention and Control, Beijing 100021, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2011 Mar;45(3):244-8.
To explore the major risk factors for upper gastrointestinal cancer in high occurrence areas of esophageal and gastric cancer in China.
Four high occurrence areas of esophageal cancer, namely Cixian and Shexian from Hebei province, Linxian from Henan province, Feicheng from Shandong province, and Zhuanghe from Liaoning province, which is a high occurrence area of gastric cancer, were selected for the study. The newly-diagnosed cases whose date of onset were after January 1st, 2009 were selected from the Cancer Registration Database in each district, and 751 cases diagnosed as cancers in lower segment of esophagus, cardiac and other subsite of stomach were randomly recruited. 2253 matched controls were selected to pair the cases at the ratio of 3:1. The relative information of the study objects were collected from the face-to-face interviews with trained staff by designed questionnaires, and the data was input by EpiData software. Statistic software SPSS 13.0 was applied to conduct both univariate and multivariate logistic regression analysis to evaluate odd ratios (OR) and 95% confident interval (CI).
As univariate analysis shown, 66 objects in case group had irregular diet habit; while 90 in control group had (OR = 3.177; 95%CI: 2.127 - 4.745). A higher percentage in case group (83 objects) preferred fried food in comparison with only 214 in control group did (OR = 3.190; 95%CI: 2.061 - 4.927). 369 objects in case group, but only 119 in control group had history of gastrointestinal diseases (OR = 14.660; 95%CI: 11.342 - 18.948). 282 objects in case group had history of gastroesophageal reflux disease (GERD), which was much higher than the percentage in control group (432 objects), with OR = 3.137 (95%CI: 2.546 - 3.864). All the above factors could increase the risk for upper gastrointestinal cancer. 387 objects in case group and 1278 in control group reported they preferred fresh vegetables in daily diet, which was found to be a protective factor (OR = 0.609; 95%CI: 0.473 - 0.785). As multivariate analysis shown, history of gastrointestinal tract diseases (OR = 21.420; 95%CI: 15.484 - 29.632), irregular food diet (OR = 3.097; 95%CI: 1.740 - 5.514), pickled food (OR = 3.005; 95%CI: 1.873 - 4.819), and GERD (OR = 2.261; 95%CI: 1.673 - 3.057) were found to be risk factors for upper gastrointestinal cancer; while frequent fresh-vegetable diet was a protective factor (OR = 0.562; 95%CI: 0.396 - 0.800).
Irregular lifestyle and unhealthy diet habit could be the major risk factors for upper gastrointestinal cancers among the residents from high occurrence areas of esophageal cancer and gastric cancer in China.
探讨中国食管癌和胃癌高发地区上消化道癌的主要危险因素。
选取河北省磁县和涉县、河南省林县、山东省肥城市这4个食管癌高发地区，以及辽宁省庄河市这个胃癌高发地区进行研究。从各地区癌症登记数据库中选取发病日期在2009年1月1日之后的新诊断病例，随机招募751例被诊断为食管下段癌、贲门癌和胃其他亚部位癌的患者。按照3∶1的比例选取2253例匹配对照与病例进行配对。通过设计好的问卷，由经过培训的工作人员面对面访谈收集研究对象的相关信息，并使用EpiData软件录入数据。应用统计软件SPSS 13.0进行单因素和多因素logistic回归分析，以评估比值比（OR）和95%置信区间（CI）。
单因素分析显示，病例组有66例对象饮食习惯不规律；而对照组有90例（OR = 3.177；95%CI：2.127 - 4.745）。病例组中偏好油炸食品的比例较高（83例对象），而对照组仅有214例（OR = 3.190；95%CI：2.061 - 4.927）。病例组有369例对象有胃肠道疾病史，而对照组仅有119例（OR = 14.660；95%CI：11.342 - 18.948）。病例组有282例对象有胃食管反流病（GERD）病史，远高于对照组的比例（43例对象），OR = 3.137（95%CI：2.546 - 3.864）。上述所有因素均会增加上消化道癌的发病风险。病例组有387例对象，对照组有1278例对象报告他们在日常饮食中偏好新鲜蔬菜，这被发现是一个保护因素（OR = 0.609；95%CI：0.473 - 0.785）。多因素分析显示，胃肠道疾病史（OR = 21.420；95%CI：15.484 - 29.632）、饮食不规律（OR = 3.097；95%CI：1.740 - 5.514）、腌制食品（OR = 3.005；95%CI：1.873 - 4.819）和胃食管反流病（OR = 2.261；95%CI：1.673 - 3.057）被发现是上消化道癌的危险因素；而经常食用新鲜蔬菜是一个保护因素（OR = 0.562；95%CI：0.396 - 0.800）。
生活方式不规律和不健康的饮食习惯可能是中国食管癌和胃癌高发地区居民上消化道癌的主要危险因素。
