Gao Y T, McLaughlin J K, Blot W J, Ji B T, Benichou J, Dai Q, Fraumeni J F
Department of Epidemiology, Shanghai Cancer Institute, People's Republic of China.
Int J Cancer. 1994 Jul 15;58(2):192-6. doi: 10.1002/ijc.2910580208.
A population-based case-control study of esophageal cancer was conducted in urban Shanghai involving interviews with 902 cases and 1,552 controls. Risk of esophageal cancer was increased among tobacco smokers and alcohol drinkers. Odds ratios (OR) for smoking were 2.1 and 1.6 for men and women, respectively, and increased with number of cigarettes smoked per day, duration of smoking, number of pack-years and decreasing age at start of smoking. For men who were current alcohol drinkers OR was 1.4, with the excess risk primarily among heavy drinkers. Few women drank alcoholic beverages. The combined effect of heavy smoking and drinking among men was pronounced: OR was 12.0 for those who smoked more than 1 pack per day and drank more than 750 g of ethanol per week. The relation with smoking appeared stronger for cancers of the middle and lower thirds of the esophagus than for the upper third, while patterns of risk for squamous cell carcinoma and adenocarcinoma were similar. Heavy drinking affected all 3 subsites, with increased risks mainly limited to squamous cell carcinoma. Cigarette smoking and alcohol drinking combined accounted for almost 50% of all esophageal cancers among men in Shanghai; among women, 14% of cases were attributed to smoking. Our study confirms that smoking and drinking are important risk factors for esophageal cancer in China, thereby paralleling findings from developed countries.
在上海市区开展了一项基于人群的食管癌病例对照研究，对902例病例和1552名对照进行了访谈。吸烟者和饮酒者患食管癌的风险增加。男性和女性吸烟的优势比（OR）分别为2.1和1.6，且随着每日吸烟量、吸烟持续时间、吸烟包年数的增加以及开始吸烟年龄的降低而升高。对于当前饮酒的男性，OR为1.4，额外风险主要集中在重度饮酒者中。很少有女性饮用酒精饮料。男性中重度吸烟和饮酒的联合效应显著：对于每天吸烟超过1包且每周饮用超过750克乙醇的男性，OR为12.0。与吸烟的关联在食管中下段癌中似乎比上段癌更强，而鳞状细胞癌和腺癌的风险模式相似。重度饮酒影响所有三个亚部位，风险增加主要限于鳞状细胞癌。吸烟和饮酒合计占上海男性所有食管癌病例的近50%；在女性中，14%的病例归因于吸烟。我们的研究证实，吸烟和饮酒是中国食管癌的重要危险因素，这与发达国家的研究结果一致。
