Macfarlane G J, Zheng T, Marshall J R, Boffetta P, Niu S, Brasure J, Merletti F, Boyle P
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
Eur J Cancer B Oral Oncol. 1995 May;31B(3):181-7. doi: 10.1016/0964-1955(95)00005-3.
This combined analysis of data from three large case-control studies of oral cancer confirms the important effect of tobacco in the aetiology of the disease. The studies have been conducted in the United States, Italy and China and results for risks associated with tobacco smoking were generally consistent across centres, while those for alcohol were not; increased risks amongst alcohol drinkers were evident in two centres but not in the study conducted in Turin, Italy. In addition, the combined analysis had large enough numbers to analyse the risk of tobacco consumption in non-drinkers. In females these showed increased risks while in males the effect of tobacco alone was weaker. Given the popularity of tobacco smoking, and its consequent high attributable risk in terms of oral cancer it is reassuring, in terms of public health, that cessation will result in a substantial reduction in risk; a 30% reduction in risk for those stopping smoking between 1 and 9 years, and a 50% reduction for those stopping more than 9 years. Although encouraging smokers to stop should be the principal aim, decreases in risk for everyone could be achieved by encouraging high fruit and vegetable consumption.
这项对三项大型口腔癌病例对照研究数据的综合分析证实了烟草在该疾病病因学中的重要作用。这些研究分别在美国、意大利和中国开展，与吸烟相关风险的研究结果在各研究中心总体一致，而与饮酒相关的结果则不然；饮酒者中风险增加在两个中心较为明显，但在意大利都灵开展的研究中并非如此。此外，综合分析有足够多的数据来分析不饮酒者的烟草消费风险。在女性中这些风险有所增加，而在男性中单独烟草的影响较弱。鉴于吸烟的普遍性，以及其在口腔癌方面由此产生的高归因风险，从公共卫生角度来看，令人欣慰的是戒烟将大幅降低风险；戒烟1至9年的人风险降低30%，戒烟超过9年的人风险降低50%。虽然鼓励吸烟者戒烟应是主要目标，但通过鼓励大量食用水果和蔬菜，每个人的风险都能降低。
