Van Rensburg S J, Bradshaw E S, Bradshaw D, Rose E F
Br J Cancer. 1985 Mar;51(3):399-405. doi: 10.1038/bjc.1985.54.
The high rate of oesophageal cancer amongst southern African blacks has also been recorded amongst the Zulus. Data embracing a wide spectrum of factors pertaining to socio-economic status, nutrition, exposure to carcinogens, tobacco and alcohol usage and traditional health practices were obtained from 211 hospitalized oesophageal cancer patients and compared with hospital population controls matched for age and urban-rural background. Stepwise logistic regression analysis with adjustment for age effects showed that four of the many factors could adequately model the odds of being a cancer case. They were the daily consumption of purchased maize meal (relative risk (RR) 5.7) currently smoking commercial cigarettes (RR 2.6), pipe smoking (RR 2.1), and a reduction of risk in those using butter or margarine daily (RR 0.51). Further significant differences (P less than 0.05) in 12 other factors suggest that those with rural assets but an ability to earn a modest income external to the subsistence economy are at highest risk. They represent a transitional state of Westernisation which is characterised by excessive smoking habits and a diet having a low vitamin and mineral density. These results provide further evidence for the need to combat smoking and for a program of nutrient enrichment of maize meal.
南非黑人中较高的食管癌发病率在祖鲁族中也有记录。从211名住院食管癌患者那里获取了一系列与社会经济地位、营养、接触致癌物、烟草和酒精使用以及传统健康习惯等相关因素的数据，并与年龄和城乡背景相匹配的医院普通人群对照组进行了比较。在对年龄效应进行调整的逐步逻辑回归分析中发现，众多因素中的四个能够充分模拟患癌几率。它们分别是每日食用购买的玉米粉（相对风险（RR）5.7）、目前吸食商业香烟（RR 2.6）、吸食烟斗（RR 2.1）以及每日使用黄油或人造黄油者风险降低（RR 0.51）。其他12个因素存在进一步的显著差异（P小于0.05），这表明那些拥有农村资产但有能力在自给经济之外赚取适度收入的人风险最高。他们代表了一种西化的过渡状态，其特点是吸烟习惯过度以及饮食中维生素和矿物质含量低。这些结果为控烟以及玉米粉营养强化计划的必要性提供了进一步证据。
