中国女性乳腺癌人群归因危险估计  

Population-attributable risk estimates for breast cancer in Chinese females

作　　者：胡晓凤[1] 姜勇[2] 曲宸绪[2] 王建炳 陈万青[4] 李辉[5] 乔友林[2] 

机构地区：[1]北京协和医学院公共卫生学院,100005 [2]中国医学科学院北京协和医学院肿瘤医院肿瘤研究所流行病学研究室 [3]NutritionalEpidemiologyBranch,DivisionofCancerEpidemiologyandGenetics,NationalCancerInstitute,Rockville,USA,20852 [4]全国肿瘤登记中心全国肿瘤防治研究 [5]中国医学科学院北京协和医学院基础医学院流行病学研究室

出　　处：《中华肿瘤杂志》2013年第10期796-800,共5页Chinese Journal of Oncology

摘　　要：目的 评估已知乳腺癌危险因素对我国女性人群的人群归因危险,为中国女性乳腺癌的预防与控制提供依据.方法 利用文献中人群暴露率和相对危险度的数据,计算已知危险因素的人群归因分值（PAF）,并利用全国第三次死因调查的数据估计乳腺癌的归因死亡和发病人数.人群暴露率的数据主要来源于大样本、大范围的代表全国人群的调查数据,相对危险度的数据来自Meta分析研究和中国或其他国家的大样本的单个研究资料.结果 居前5位的乳腺癌发病的危险因素依次为良性乳腺疾病（RR =2.62）、乳腺癌家族史（RR =2.39）、吸烟（RR=l.86）、超重（RR=1.60）和月经初潮年龄（RR=l.54）.生殖因素、生活方式、良性乳腺疾病、外源性激素治疗及乳腺癌家族史的PAF分别为27.84％、23.55％、15.09％、3.60％和2.49％,五大危险因素总PAF为55.95％.2005年,我国女性乳腺癌归因于生殖因素、生活方式、良性乳腺疾病、外源性激素治疗及乳腺癌家族史的发病和死亡人数分别为79 862和22 456例.结论 预防控制各种不良生活方式将可能显著降低中国乳腺癌发病与死亡.Objective To estimate the contribution of known identified risk factors to breast cancer incidence and mortality in China, and provide evidence to support the prevention and control of breast cancer for Chinese females. Methods We calculated the proportion of breast cancer attributable to specific risk factors. Data on exposure prevalence were obtained from Meta-analyses and large-scale national surveys of representative samples of the Chinese population. Data on relative risks were obtained from Meta-analyses and large-scale prospective studies. Cancer mortality and incidence were taken from the Third National Death Survey and from cancer registries in China. Results The first 5 risk factors of breast cancer in China were benign breast disease （ RR = 2.62 ）, family history of breast cancer （ RR = 2.39 ）, smoking （ RR = 1.86 ）, overweight （RR = 1.60 ） and age at menarche （ RR = 1. 54 ）. The proportion of breast cancer deaths attributable to reproductive factors, lifestyle factors, benign breast disease, the use of external hormone and family history of breast cancer was 27.84%, 23.55%, 15.09%, 3.60% and 2.49%, respectively. The total population attributable fraction （PAF） was 55.95% for risk factors in our study. Overall, we estimated that 79 862 breast cancer cases and 22 456 deaths were attributed to the five risk factors in China in 2005. Conclusions The prevention and control of unhealthy lifestyle factors may significantly reduce the number and death of breast cancer in China.

关 键 词：乳腺肿瘤 危险因素 人群归因分值 发病率 死亡 

分 类 号：R737.9[医药卫生—肿瘤]