Gao Jing, Yang Gong, Wen Wanqing, Cai Qiu-Yin, Zheng Wei, Shu Xiao-Ou, Xiang Yong-Bing
aState Key Laboratory of Oncogene and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China bDepartment of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Eur J Cancer Prev. 2016 Jul;25(4):329-34. doi: 10.1097/CEJ.0000000000000178.
This study aimed to provide data on the impact of known risk factors on endometrial cancer burden. Using data on 1199 endometrial cancer cases and 1212 frequency matched controls from a population-based case-control study carried out in urban Shanghai, China from 1997 to 2003, multivariable adjusted odds ratios were obtained from unconditional logistic regression analyses. Partial population-attributable risks were calculated and corresponding 95% confidence intervals were estimated using a bootstrap method. An estimated 16.94% of endometrial cancer cases were attributed to overweight or obesity; 8.39% to meat intake; 5.45% to nonregular tea drinking; 5.23% to physical inactivity; and 1.77% to family history of endometrial, breast, or colorectal cancers. Overall, these risk factors accounted for 36.01% (95% confidence interval: 28.55-43.11%) of total endometrial cancer cases. Similar results were observed when analysis was restricted to postmenopausal women. Among modifiable lifestyle factors, overweight and obesity accounted for the largest proportion of endometrial cancer in the study population. Lifestyle alterations, such as maintenance of healthy weight, regular exercise, consumption of less meat, and tea drinking, could potentially reduce endometrial cancer by more than one-third.
本研究旨在提供有关已知风险因素对子宫内膜癌负担影响的数据。利用1997年至2003年在中国上海市区开展的一项基于人群的病例对照研究中1199例子宫内膜癌病例和1212例频率匹配对照的数据，通过无条件逻辑回归分析获得多变量调整后的比值比。计算部分人群归因风险，并使用自助法估计相应的95%置信区间。估计16.94%的子宫内膜癌病例归因于超重或肥胖；8.39%归因于肉类摄入；5.45%归因于不经常饮茶；5.23%归因于缺乏身体活动；1.77%归因于子宫内膜癌、乳腺癌或结直肠癌家族史。总体而言，这些风险因素占子宫内膜癌病例总数的36.01%（95%置信区间：28.55 - 43.11%）。当分析仅限于绝经后妇女时，观察到类似结果。在可改变的生活方式因素中，超重和肥胖在研究人群的子宫内膜癌中占比最大。生活方式的改变，如保持健康体重、定期锻炼、少吃肉和饮茶，有可能将子宫内膜癌减少三分之一以上。
