La Vecchia C, Decarli A
Istituto di Ricerche Farmacologiche Mario Negri, Milano.
Ann Ist Super Sanita. 1996;32(4):551-6.
After early rises, oesophageal cancer mortality rates have tended to level off in Italy over the last two decades, and are now intermediate on a European scale (4.7/100000 males, 0.8/100000 females, world standard). This reflects the trends in consumption of the major risk factors for the disease, tobacco and alcohol, particularly in men. Within Italy, there is also a substantial variation in oesophageal cancer rates, with high mortality areas in the North-East of the country. On the basis of a case-control study conducted in northern Italy, the relative risk (RR) of the disease was 4.3 in heavy smokers and 3.5 in heavy drinkers. A diet poor in fresh fruit and vegetables was also related to the risk of the disease (RR = 2.5). In terms of population attributable risk, 71% of cases in men and 32% in women were accounted for tobacco smoking, 45% in males and 10% in females by alcohol drinking, 40% in men and 29% in women by a diet poor in fresh fruit and vegetables (and hence in beta-carotene). These three factors together accounted for 90% of cases in Italian men, and 58% in women (83% in both sexes combined).
在早期上升之后，过去二十年来意大利的食管癌死亡率趋于平稳，目前在欧洲范围内处于中等水平（男性为4.7/10万，女性为0.8/10万，世界标准）。这反映了该疾病主要危险因素烟草和酒精的消费趋势，尤其是在男性中。在意大利国内，食管癌发病率也存在很大差异，该国东北部为高死亡率地区。根据在意大利北部进行的一项病例对照研究，重度吸烟者患该病的相对风险（RR）为4.3，重度饮酒者为3.5。新鲜水果和蔬菜摄入量低的饮食也与该病风险相关（RR = 2.5）。就人群归因风险而言，男性病例的71%和女性病例的32%可归因于吸烟，男性病例的45%和女性病例的10%可归因于饮酒，男性病例的40%和女性病例的29%可归因于新鲜水果和蔬菜（以及β-胡萝卜素）摄入量低的饮食。这三个因素共同导致了意大利男性病例的90%和女性病例的58%（男女合计为83%）。
