Feychting M, Osterlund B, Ahlbom A
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Epidemiology. 1998 Sep;9(5):490-4.
Melatonin is a hormone primarily produced by the pineal gland at night and is suppressed by exposure to light. Experimental studies have indicated that melatonin may protect against cancer development. In the majority of totally blind people, melatonin is never suppressed by light exposure. The aim of this study was to test the hypothesis that blind people have a decreased cancer incidence, and that this effect is more pronounced in the totally blind than in the severely visually impaired. We identified a cohort of 1,567 totally blind and 13,292 severely visually impaired subjects and obtained information about cancer incidence from the Swedish Cancer Registry. We calculated standardized incidence ratios (SIRs) based on the number of person-years and incidence rates specific for national age, sex, and calendar year. Totally blind people had a lower incidence of all cancers combined [SIR = 0.69; 95% confidence interval (CI) = 0.59-0.82]. The risk reduction was observed in both men and women and was equally pronounced in hormone-dependent tumors as in other types of cancer. In the severely visually impaired, SIR was 0.95 (95% CI = 0.91-1.00). The findings support the hypothesis that blind people have a lower cancer incidence, although other explanations than the higher melatonin exposure must also be considered.
褪黑素是一种主要由松果体在夜间分泌的激素,且会因暴露于光线下而受到抑制。实验研究表明,褪黑素可能对癌症发展具有预防作用。在大多数全盲人群中,褪黑素不会因暴露于光线下而受到抑制。本研究的目的是检验以下假设:盲人的癌症发病率降低,且这种效应在全盲人群中比在严重视力受损人群中更为明显。我们确定了一个由1567名全盲和13292名严重视力受损受试者组成的队列,并从瑞典癌症登记处获取了有关癌症发病率的信息。我们根据人年数以及特定于国家年龄、性别和日历年的发病率计算了标准化发病率(SIR)。全盲人群所有癌症合并发病率较低[SIR = 0.69;95%置信区间(CI)= 0.59 - 0.82]。在男性和女性中均观察到风险降低,且在激素依赖性肿瘤和其他类型癌症中同样明显。在严重视力受损人群中,SIR为0.95(95%CI = 0.91 - 1.00)。这些发现支持了盲人癌症发病率较低这一假设,不过也必须考虑除较高褪黑素暴露之外的其他解释。