Institut national de santé publique du Québec, chemin Sainte-Marie, Sainte-Anne-de-Bellevue, Québec, Canada.
Cancer Epidemiol. 2012 Apr;36(2):e83-8. doi: 10.1016/j.canep.2011.11.008. Epub 2011 Dec 19.
It has been suggested that fluoride in drinking water may increase the risk of osteosarcoma in children and adolescents, although the evidence is inconclusive. We investigated the association between community water fluoridation (CWF) and osteosarcoma in childhood and adolescence in the continental U.S.
We used the cumulative osteosarcoma incidence rate data from the CDC Wonder database for 1999-2006, categorized by age group, sex and states. States were categorized as low (≤30%) or high (≥85%) according to the percentage of the population receiving CWF between 1992 and 2006. Confidence intervals for the incidence rates were calculated using the Gamma distribution and the incidence rates were compared between groups using Poisson regression models.
We found no sex-specific statistical differences in the national incidence rates in the younger groups (5-9, 10-14), although 15-19 males were at higher risk to osteosarcoma than females in the same age group (p<0.001). Sex and age group specific incidence rates were similar in both CWF state categories. The higher incidence rates among 15-19 year old males vs females was not associated with the state fluoridation status. We also compared sex and age specific osteosarcoma incidence rates cumulated from 1973 to 2007 from the SEER 9 Cancer Registries for single age groups from 5 to 19. There were no statistical differences between sexes for 5-14 year old children although incidence rates for single age groups for 15-19 year old males were significantly higher than for females.
Our ecological analysis suggests that the water fluoridation status in the continental U.S. has no influence on osteosarcoma incidence rates during childhood and adolescence.
有人认为饮用水中的氟化物可能会增加儿童和青少年罹患骨肉瘤的风险，但目前证据尚不确定。我们在美国大陆调查了社区饮水氟化（CWF）与儿童和青少年骨肉瘤之间的关联。
我们使用了 CDC Wonder 数据库中 1999-2006 年的累计骨肉瘤发病率数据，按年龄组、性别和州进行分类。根据 1992 年至 2006 年接受 CWF 的人口比例，各州分为低（≤30%）或高（≥85%）两类。使用伽马分布计算发病率的置信区间，并使用泊松回归模型比较组间发病率。
我们发现，在年轻组（5-9、10-14 岁）中，全国发病率没有性别特异性差异，尽管在同一年龄组中，15-19 岁男性罹患骨肉瘤的风险高于女性（p<0.001）。在 CWF 州分类中，男女和年龄组的发病率相似。15-19 岁男性的发病率高于女性，与州氟化状态无关。我们还比较了来自 SEER 9 癌症登记处的 1973 年至 2007 年单一年龄组（5-19 岁）的男女和年龄特异性骨肉瘤发病率。对于 5-14 岁的儿童，性别之间没有统计学差异，尽管 15-19 岁男性的单一年龄组发病率明显高于女性。
我们的生态分析表明，美国大陆的水氟化状态对儿童和青少年时期的骨肉瘤发病率没有影响。
