Parkin D M, Vizcaino A P, Skinner M E, Ndhlovu A
Unit of Descriptive Epidemiology, International Agency for Research on Cancer, Lyon, France.
Cancer Epidemiol Biomarkers Prev. 1994 Oct-Nov;3(7):537-47.
The incidence of cancer and the importance of some selected risk factors in its etiology were estimated from the data collected in the cancer registry of Bulawayo, Zimbabwe, during the period 1963-1977. Cancer cases were interviewed with a standard questionnaire, and more than 71% of these were complete. In men, the most frequent cancer sites were liver, esophagus, and lung, while in women, cervical cancer was the dominant malignant tumor, followed by cancers of the liver, breast, and bladder. Risk factors of cancer cases were estimated by case-control analysis in which other cancers (excluding tobacco-related cancers in men and hormone-related cancers in women) were considered as controls. In men, tobacco smoking was associated with increased risk of lung cancer (odds ratio OR2, 5.2) and esophagus cancer (OR, 5.6) in the highest consumption category (15 g of tobacco per day) compared to nonsmokers. Copper (OR, 1.5), gold (OR, 1.5), and nickel (OR, 2.6) miners had an increased risk of lung cancer, but no increase was found among asbestos miners (OR, 0.7). There was no independent effect of alcohol consumption on the risk of esophagus cancer. The presence of schistosomiasis was associated with a significantly increased risk of bladder cancer (OR, 3.9). The risk of invasive cervical cancer increased with number of children--the estimated odds ratio was 1.8 in women with six or more births--but no consistent association was found for first intercourse. In postmenopausal women, the risk of breast cancer increased with age at first pregnancy (but not in the highly fertile) and decreased with high parity, if age at first pregnancy was 19 or more.
根据1963年至1977年期间在津巴布韦布拉瓦约癌症登记处收集的数据，对癌症发病率及其病因中一些选定风险因素的重要性进行了评估。使用标准问卷对癌症病例进行了访谈，其中超过71%的访谈是完整的。在男性中，最常见的癌症部位是肝脏、食管和肺，而在女性中，宫颈癌是主要的恶性肿瘤，其次是肝癌、乳腺癌和膀胱癌。通过病例对照分析估计癌症病例的风险因素，其中将其他癌症（男性中排除与烟草相关的癌症，女性中排除与激素相关的癌症）视为对照。在男性中，与不吸烟者相比，在最高消费类别（每天15克烟草）中，吸烟与肺癌（优势比OR2，5.2）和食管癌（OR，5.6）风险增加有关。铜矿工（OR，1.5）、金矿工（OR，1.5）和镍矿工（OR，2.6）患肺癌的风险增加，但石棉矿工中未发现风险增加（OR，0.7）。饮酒对食管癌风险没有独立影响。血吸虫病的存在与膀胱癌风险显著增加有关（OR，3.9）。浸润性宫颈癌的风险随着子女数量增加——估计生育6个或更多子女的女性的优势比为1.8——但首次性交未发现一致的关联。在绝经后女性中，如果首次怀孕年龄为19岁或更大，则乳腺癌风险随着首次怀孕年龄增加（但在高生育率女性中并非如此）且随着高生育次数而降低。
