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意大利污染场地的癌症发病率。

Cancer incidence in Italian contaminated sites.

机构信息

Dipartimento di Ambiente e Connessa Prevenzione Primaria, Istituto Superiore di Sanità, Rome, Italy. E-mail:

出版信息

Ann Ist Super Sanita. 2014;50(2):186-91. doi: 10.4415/ANN_14_02_13.

Abstract

INTRODUCTION

The incidence of cancer among residents in sites contaminated by pollutants with a possible health impact is not adequately studied. In Italy, SENTIERI Project (Epidemiological study of residents in National Priority Contaminated Sites, NPCSs) was implemented to study major health outcomes for residents in 44 NPCSs.

METHODS

The Italian Association of Cancer Registries (AIRTUM) records cancer incidence in 23 NPCSs. For each NPCSs, the incidence of all malignant cancers combined and 35 cancer sites (coded according to ICD-10), was analysed (1996-2005). The observed cases were compared to the expected based on age (5-year period,18 classes), gender, calendar period (1996-2000; 2001-2005), geographical area (North-Centre and Centre-South) and cancer sites specific rates. Standardized Incidence Ratios (SIR) with 90% Confidence Intervals were computed.

RESULTS

In both genders an excess was observed for overall cancer incidence (9% in men and 7% in women) as well as for specific cancer sites (colon and rectum, liver, gallblad-der, pancreas, lung, skin melanoma, bladder and Non Hodgkin lymphoma). Deficits were observed for gastric cancer in both genders, chronic lymphoid leukemia (men), malignant thyroid neoplasms, corpus uteri and connective and soft-tissue tumours and sarcomas (women).

DISCUSSION

This report is, to our knowledge, the first one on cancer risk of residents in NPCSs. The study, although not aiming to estimate the cancer burden attributable to the environment as compared to occupation or life-style, supports the credibility of an etiologic role of environmental exposures in contaminated sites. Ongoing analyses focus on the interpretation of risk factors for excesses of specific cancer types overall and in specific NPCSs in relation to the presence of carcinogenic pollutants.

摘要

简介

受可能对健康造成影响的污染物污染地区的居民癌症发病率尚未得到充分研究。在意大利,SENTIERI 项目(国家优先污染场地居民的流行病学研究,NPCSs)旨在研究 44 个 NPCSs 中居民的主要健康结果。

方法

意大利癌症登记协会(AIRTUM)记录了 23 个 NPCSs 的癌症发病率。对于每个 NPCSs,分析了所有恶性癌症合并和 35 个癌症部位(根据 ICD-10 编码)的发病率(1996-2005 年)。观察病例与基于年龄(5 年期间,18 个类别)、性别、日历期(1996-2000 年;2001-2005 年)、地理区域(北部-中部和中部-南部)和癌症部位特定发病率的预期病例进行比较。计算了标准化发病比(SIR)及其 90%置信区间。

结果

在男女两性中,整体癌症发病率均偏高(男性为 9%,女性为 7%),特定癌症部位(结肠和直肠、肝脏、胆囊、胰腺、肺、皮肤黑色素瘤、膀胱和非霍奇金淋巴瘤)也偏高。两性的胃癌、慢性淋巴细胞白血病(男性)、甲状腺恶性肿瘤、子宫体、结缔组织和软组织肿瘤和肉瘤(女性)发病率偏低。

讨论

据我们所知,这是第一份关于 NPCSs 居民癌症风险的报告。该研究虽然不是为了估计与职业或生活方式相比环境对癌症的负担,但支持了环境暴露在污染场地中致癌的病因作用的可信度。正在进行的分析侧重于解释总体和特定 NPCSs 中特定癌症类型的风险因素与致癌污染物的存在之间的关系。

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