我国966个食管癌高发县产生的原因及预防措施探讨  

The causes and preventive measures in China's 966 counties having a high incidence of esophageal cancer

作　　者：韩建英[1] 徐致祥[2] 邢海平[1] 谭家驹[2] 陈凤兰[2] 王民宪[1] 孔芳君[1] 张栓虎[1] 吴校连[2] 李笑梅[1] 李金辉[1] 郭鹏飞[1] 

机构地区：[1]安阳市疾病预防控制中心,河南安阳455000 [2]佛山市第一人民医院,广东佛山528000

出　　处：《河南预防医学杂志》2009年第1期1-4,共4页Henan Journal of Preventive Medicine

基　　金：广东省自然科学基金项目(04008530);安阳市社会发展攻关项目立项(23)

摘　　要：目的探讨我国2 460个县中966个食管癌高发县产生的原因及预防措施。方法对1972年-1975年全国29个省、2 460个县、8.5亿人口3年回顾食管癌死亡调查资料与全国气候、产煤基地、河流、地形等环境资料进行统计分析。结果(1)全国2 460个县,98.25%的县食管癌死亡率大于零。全国平均值为15/10万,高于平均值的县(16/10万以上)有966个,占39%,低于平均值的县(15/10万以下)1494个,占61%。(2)从平均气温看:7月份平均气温在25℃-26℃554个县,气温27℃400个县,食管癌死亡率均较高,分别为22.45/10万,33.25/10万;气温20℃以下293个县,死亡率为8.57/10万,气温28℃377个县,死亡率为13.96/10,气温过高或过低的县死亡率均较低;从气候类型看:中温带半干湿季风气候区县食管癌死亡率较高;(3)全国2 460个县食管癌死亡率与煤矿基地成等级正相关,等级相关系数0.9643。食管癌高发县占调查总数的39%,却拥有全国80%的煤矿基地;(4)有河流的县食管癌死亡率41.89/10万,高于远离河流的县29.49/10万,差异有统计学意义,高发区多分布在海河水系;淮河水系;黄河中、下游;长江中、下游地区;(5)山区县食管癌死亡率较高。山区县46.15/10万>过度区县42.48/10万>平原区县27.68/10万,成阶梯状递减。主要集中在晋、冀、豫太行山、陕鄂豫秦岭、鄂豫皖大别山、四川盆地西北部、苏北、新疆西北部、福建南部与广东省东部汕头梅县地区等山区。(6)全国1476个县(不包括高原),食管癌死亡率低于16/10万,没有山区高发现象,而是平原区死亡率7.57/10万>山区5.59/10万。总之,温带、半干旱气候区、煤矿开采区及下游大范围的山区居民食管癌高发,这是因为山区居民终生饮用污染的河水、渠水、河边井水、山泉水等,使人群有效污染比率高,饮用水中,可能含有亚硝基化合物前体物。而在饮用地下水的平原区县居民,食管癌低发。预防控制的重�Objective To explore the causes and preventive measures in 2,460 counties of Chinag 966 counties having a high incidence of esophageal cancer. Method It is statistical analysis between the three years survey data died of esophageal cancer of 29 provinces and 2,460 counties, 850 million people in1972 -1975 to the national coal production bases, terrain, rivers, temperature and other environmental information. Results In 2460 survey counties, 98.25 percent of counties have varying degrees of esophageal cancer occurred. 966 Counties that the mortality is more than 16/100000 is 39 percent in 2460 counties. 408 Counties as more than 32/100000 is 16.58 percent in 2460 counties. 126 counties above 64/10000 is 5.12 percent in 2460 counties. The mortality rates of esophageal cancer are higher, respectively 22.45/10000 and 33.25/10 in 554 counties in July the average temperature of 25 - 26 degrees and 400 counties the average temperature of 27 degrees. The temperature is too high or too low. County mortality rates are lower. The temperate climate is mainly the semi - wet and dry climate in the high mortality rates of County. 966 Counties that the mortality is more than 16/100000 is 39 percent of the total number of investigations, but have 80 percent of the coal bases. The esophageal cancer mortality （41.89/100000）with rivers in the 966 counties is higher than the counties （29.49/100000） away from the river and the differences were Significance. The mortality （ 46. 15/100000 ） in mountain counties with rivers is higher than counties （ 42.48/ 100000 ） from mountain to Plain and is higher than Plain （ 27.68/100000）, a ladder descending. The plain mortality （ 7.57/ 100000） is higher than mountain （5.59/100000） in 1476 counties （ not including the plateau） , esophageal cancer mortality rate beow 16/100000. Conclusion The high incidence of esophageal cancer in semi - wet and dry climate is related that the large crowd drinking lower pollution water with lifetime as the river water, mountain sprin

关 键 词：食管癌高发县 原因 预防措施 

分 类 号：R735.1[医药卫生—肿瘤]