Tavani A, Negri E, Franceschi S, La Vecchia C
Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Eur J Cancer Prev. 1996 Oct;5(5):313-8. doi: 10.1097/00008469-199610000-00002.
Information on the aetiology of oesophageal cancer in alcohol non-drinkers will help us to understand and quantitate risk factors for the disease in the absence of alcohol. Out of a total of 316 cases with histologically confirmed incident cancers of the oesophagus, 40 (22 men and 18 women) who described themselves as alcohol non-drinkers were considered. These patients were compared with 151 alcohol non-drinkers (79 men and 72 women) admitted to hospital for acute, non-neoplastic, non-alcohol-, non-smoking-related conditions. The major risk factor for cancer of the oesophagus in non-drinkers was current elevated cigarette smoking: compared with never smokers, the odds ratio (OR) for all current smokers was 3.4 [95% confidence interval (CI), 1.5-8.1]. The OR was 0.8 (95% CI 0.2-3.4) for ex-smokers, 1.3 (95% CI 0.4-4.2) for current smokers of fewer than 20 cigarettes per day and 7.5 (95% CI 2.7-20.4) for current smokers of more than 20 cigarettes per day. Risk also increased with duration of smoking (OR 4.9 for more than 30 years smoking), and in smokers starting the habit when aged 25 or younger (OR 3.9). Few years of education and gastrectomy were also associated with elevated risk, while a high fruit intake was associated with reduced risk (OR 0.6 and 0.4, respectively, for 7-13 and > 13 portions per week compared with < 7). When the combined effect of smoking and fruit intake on the risk of oesophageal cancer was considered, compared with non-smokers eating more than 7 fruit portions per week, the OR for current smokers eating 7 or less fruit portions per week was 7.3. Thus, even in the absence of alcohol drinking, cigarette smoking and a diet poor in fruit are important avoidable risk factors for oesophageal cancer.
了解不饮酒者食管癌的病因信息将有助于我们理解和量化无酒精情况下该疾病的风险因素。在总共316例经组织学确诊的食管癌新发病例中，有40例（22名男性和18名女性）自称不饮酒者被纳入研究。这些患者与151名因急性、非肿瘤性、与酒精和吸烟无关的疾病入院的不饮酒者（79名男性和72名女性）进行了比较。不饮酒者患食管癌的主要风险因素是当前吸烟量增加：与从不吸烟者相比，所有当前吸烟者的比值比（OR）为3.4 [95%置信区间（CI），1.5 - 8.1]。既往吸烟者的OR为0.8（95% CI 0.2 - 3.4），每天吸烟少于20支的当前吸烟者的OR为1.3（95% CI 0.4 - 4.2），每天吸烟超过20支的当前吸烟者的OR为7.5（95% CI 2.7 - 20.4）。风险也随着吸烟持续时间增加（吸烟超过30年的OR为4.9），以及在25岁及以下开始吸烟习惯的吸烟者中增加（OR为3.9）。受教育年限少和胃切除术也与风险升高有关，而高水果摄入量与风险降低有关（与每周少于7份相比，每周7 - 13份和超过13份的OR分别为0.6和0.4）。当考虑吸烟和水果摄入量对食管癌风险的综合影响时，与每周食用超过7份水果的非吸烟者相比，每周食用7份或更少水果的当前吸烟者的OR为7.3。因此，即使不饮酒，吸烟和水果摄入不足也是食管癌重要的可避免风险因素。
