吸烟和环境烟草烟雾暴露与膀胱癌关系的病例对照研究  

Relationship between smoking and exposure to environmental tobacco smoking with bladder cancer:a case-control study in Shanghai

作　　者：张薇[1] 项永兵[1] 邵常霞[1] 方茹蓉[1] 程家蓉[1] 袁剑敏 高玉堂[1] 

机构地区：[1]上海交通大学肿瘤研究所/上海市肿瘤研究所流行病学研究室 [2]Division of Epidemiology and Community Health,University of Southern California,Los Angeles CA90089-9176,USA

出　　处：《肿瘤》2006年第1期42-47,共6页Tumor

摘　　要：目的：研究分析吸烟及环境烟草烟雾暴露与膀胱癌的关系。方法：自1996年1月～1999年6月，上海市区开展了一项大规模的基于全人群的膀眈癌病例对照研究，共访问到608倒膀胱癌病例和607例健康人群对照。使用非条件logistic回归分析，调整可能的混杂因素，估计吸烟及环境烟草烟雾暴露对膀胱癌发生的比数比和95％可信区间。结果：男性吸烟者患膀胱癌的危险性是不吸烟者的1．67倍（95％CI：1．23～2．27），且随着每天吸烟量、累积吸烟量、吸烟年限和吸烟深度的增加而增加，吸烟开始年龄越小危险性越大；戒烟后膀胱癌危险性有所降低。吸烟也显著增加女性膀胱癌的危险性，调整OR为4．19（95％CI：1．65～10．65）。吸烟者的调整人群归因危险度男性、女性分别为32．04％和15．61％。未发现环境烟草暴露增加非吸烟者膀胱癌的危险性。结论：进一步证实吸烟是膀胱癌发生的重要危险因素。环境烟草烟雾暴露是否增加膀胱癌危险性尚难定论。Objective：To evaluate the relationship between smoking and environmental tobacco smoking（ETS）with the risk of bladder cancer. Methods：A population based case-control study was conducted in Shanghai from Jan 1996 to Jun 1999. The dataset included 608 bladder cancer cases and 607 controls frequency matched for age and gender within 5 years. Detailed information on tobacco and ETS was collected through in-person interviews. Unconditional logistic regression models were used in the analysis to adjust potential confounding factors and to obtain maximum likelihood estimates of the odds ratios （ORs） and 95 confidence intervals（CIs）. Results：Cigarette smoking was associated with a statistically significant 67% increase in the bladder cancer risk in man（OR=l. 67;95%CI：1.23-2. 27）. The risk increased with increasing number of cigarettes smoked per day （two sided P 〈0.01, linear-trend test）, as well as pack year,duration of smoking and earlier age started smoking. The reduced odds ratio was observed for bladder cancer among ex cigarette smokers. Cigarette smoking increased the bladder cancer risk in women （OR=4.19;95%CI：1.65 10. 65）. It was estimated that the proportion of bladder cancer attributable to smoking was 32.04% in men and 15.61% in women, respectively. No significant relationship was found between parents smoking in childhood, husband or room inmate smoking or due to ETS exposure at work place and bladder cancer risk. Canclusion： The findings support evidence that ciga rette smoking increases the risk of bladder cancer. The effect of exposure to ETS on bladder cancer was uncertain in this study.

关 键 词：膀胱肿瘤/流行病学 吸烟 烟草烟污染 病例对照研究 

分 类 号：R737.14[医药卫生—肿瘤] R73-31[医药卫生—临床医学]