在调整社会经济地位后，城市地区多种癌症的风险更高。一项基于两国人口的18种常见癌症研究的结果。
Risk of several cancers is higher in urban areas after adjusting for socioeconomic status. Results from a two-country population-based study of 18 common cancers.
作者信息
Sharp Linda, Donnelly David, Hegarty Avril, Carsin Anne-Elie, Deady Sandra, McCluskey Neil, Gavin Anna, Comber Harry
机构信息
National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland,
出版信息
J Urban Health. 2014 Jun;91(3):510-25. doi: 10.1007/s11524-013-9846-3.
Some studies suggest that there are urban-rural variations in cancer incidence but whether these simply reflect urban-rural socioeconomic variation is unclear. We investigated whether there were urban-rural variations in the incidence of 18 cancers, after adjusting for socioeconomic status. Cancers diagnosed between 1995 and 2007 were extracted from the population-based National Cancer Registry Ireland and Northern Ireland Cancer Registry and categorised by urban-rural status, based on population density of area of residence at diagnosis (rural <1 person per hectare, intermediate 1-15 people per hectare, urban >15 people per hectare). Relative risks (RR) were calculated by negative binomial regression, adjusting for age, country and three area-based markers of socioeconomic status. Risks were significantly higher in both sexes in urban than rural residents with head and neck (males RR urban vs. rural = 1.53, 95 % CI 1.42-1.64; females RR = 1.29, 95 % CI 1.15-1.45), esophageal (males 1.21, 1.11-1.31; females 1.21, 1.08-1.35), stomach (males 1.36, 1.27-1.46; females 1.19, 1.08-1.30), colorectal (males 1.14, 1.09-1.18; females 1.04, 1.00-1.09), lung (males 1.54, 1.47-1.61; females 1.74, 1.65-1.84), non-melanoma skin (males 1.13, 1.10-1.17; females 1.23, 1.19-1.27) and bladder (males 1.30, 1.21-1.39; females 1.31, 1.17-1.46) cancers. Risks of breast, cervical, kidney and brain cancer were significantly higher in females in urban areas. Prostate cancer risk was higher in rural areas (0.94, 0.90-0.97). Other cancers showed no significant urban-rural differences. After adjusting for socioeconomic variation, urban-rural differences were evident for 12 of 18 cancers. Variations in healthcare utilization and known risk factors likely explain some of the observed associations. Explanations for others are unclear and, in the interests of equity, warrant further investigation.
一些研究表明，癌症发病率存在城乡差异，但这些差异是否仅仅反映了城乡社会经济差异尚不清楚。我们在调整社会经济地位后，调查了18种癌症的发病率是否存在城乡差异。1995年至2007年间诊断出的癌症病例从基于人群的爱尔兰国家癌症登记处和北爱尔兰癌症登记处提取，并根据诊断时居住地区的人口密度按城乡状况进行分类（农村<1人/公顷，中间值1 - 15人/公顷，城市>15人/公顷）。通过负二项回归计算相对风险（RR），并对年龄、国家和三个基于地区的社会经济地位指标进行调整。城市居民中，头颈部癌（男性RR城市 vs. 农村 = 1.53，95% CI 1.42 - 1.64；女性RR = 1.29，95% CI 1.15 - 1.45）、食管癌（男性1.21，1.11 - 1.31；女性1.21，1.08 - 1.35）、胃癌（男性1.36，1.27 - 1.46；女性1.19，1.08 - 1.30）、结直肠癌（男性1.14，1.09 - 1.18；女性1.04，1.00 - 1.09）、肺癌（男性1.54，1.47 - 1.61；女性1.74，1.65 - 1.84）、非黑色素瘤皮肤癌（男性1.13，1.10 - 1.17；女性1.23，1.19 - 1.27）和膀胱癌（男性1.30，1.21 - 1.39；女性1.31，1.17 - 1.46）的风险在两性中均显著高于农村居民。城市地区女性乳腺癌、宫颈癌、肾癌和脑癌的风险显著更高。农村地区前列腺癌风险更高（0.94，0.90 - 0.97）。其他癌症未显示出显著的城乡差异。在调整社会经济差异后，18种癌症中有12种存在明显的城乡差异。医疗保健利用和已知风险因素的差异可能解释了一些观察到的关联。其他差异的原因尚不清楚，为了公平起见，值得进一步调查。
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