Wu-Williams A H, Dai X D, Blot W, Xu Z Y, Sun X W, Xiao H P, Stone B J, Yu S F, Feng Y P, Ershow A G
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90033.
Br J Cancer. 1990 Dec;62(6):982-7. doi: 10.1038/bjc.1990.421.
A case-control study of lung cancer involving interviews with 965 female patients and 959 controls in Shenyang and Harbin, two industrial cities which have among the highest rates of lung cancer in China, revealed that cigarette smoking is the main causal factor and accounted for about 35% of the tumours among women. Although the amount smoked was low (the cases averaged eight cigarettes per day), the percentage of smokers among women over age 50 in these cities was nearly double the national average. Air pollution from coal burning stoves was implicated, as risks of lung cancer increased in proportion to years of exposure to 'Kang' and other heating devices indigenous to the region. In addition, the number of meals cooked by deep frying and the frequency of smokiness during cooking were associated with risk of lung cancer. More cases than controls reported workplace exposures to coal dust and to smoke from burning fuel. Elevated risks were observed for smelter workers and decreased risks for textile workers. Prior chronic bronchitis/emphysema, pneumonia, and recent tuberculosis contributed significantly to lung cancer risk, as did a history of tuberculosis and lung cancer in family members. Higher intake of carotene-rich vegetables was not protective against lung cancer in this population. The findings were qualitatively similar across the major cell types of lung cancer, except that the associations with smoking and previous lung diseases were stronger for squamous/oat cell cancers than for adenocarcinoma of the lung.
一项关于肺癌的病例对照研究，对中国肺癌发病率最高的两个工业城市沈阳和哈尔滨的965名女性患者及959名对照者进行了访谈，结果显示吸烟是主要致病因素，约占女性肿瘤病例的35%。尽管吸烟量较低（病例组平均每天吸8支烟），但这些城市50岁以上女性吸烟者的比例几乎是全国平均水平的两倍。燃煤炉灶造成的空气污染也被认为与肺癌有关，因为肺癌风险随着接触“炕”及该地区其他传统取暖设备的年限增加而上升。此外，油炸烹饪的餐数和烹饪时的烟熏频率与肺癌风险相关。病例组比对照组报告有更多人在工作场所接触煤尘和燃烧燃料产生的烟雾。冶炼工人的肺癌风险升高，纺织工人的风险降低。既往慢性支气管炎/肺气肿、肺炎和近期肺结核显著增加肺癌风险，家庭成员有肺结核和肺癌病史也有同样影响。在该人群中，摄入富含胡萝卜素的蔬菜对肺癌并无预防作用。除了吸烟及既往肺部疾病与肺鳞癌/燕麦细胞癌的关联比与肺腺癌的关联更强外，肺癌主要细胞类型的研究结果在性质上相似。
