吸烟、被动吸烟与肺癌发病风险的病例对照研究  

A case-control study on smoking,passive smoking and the risk of lung cancer

作　　者：刘志强[1] 何斐[1] 蔡琳[1] 

机构地区：[1]福建医科大学公共卫生学院流行病与卫生统计学系,福建福州350108

出　　处：《中华疾病控制杂志》2015年第2期145-149,共5页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(81172766)

摘　　要：目的 探讨吸烟、被动吸烟与肺癌的关联。方法 采用病例对照研究设计,面访肺癌新发病例1303例和按性别、年龄（±2岁）频数匹配的健康对照1303例。结果 吸烟是男性肺癌的重要危险因素（调整OR=4.974,95%CI：3.933～6.291）,随着开始吸烟年龄提前、吸烟年限延长、日吸烟量、吸烟包年以及吸烟深度的增加,患肺癌危险性增高,呈剂量反应关系（Ptrend〈0.001）,戒烟≥10年患肺癌的危险性降低45.4%。男性吸烟患肺鳞癌的危险性比患肺腺癌大。被动吸烟是非吸烟者肺癌的危险因素（调整OR=1.912,95%CI：1.486～2.460）,工作环境被动吸烟的男性非吸烟者患肺癌的调整OR为2.221（95%CI：1.361～3.625）,家庭环境被动吸烟的女性非吸烟者患肺癌的调整OR为1.804（95%CI：1.270～2.562）。68.04%男性肺癌的发生可归因于吸烟,26.51%非吸烟者肺癌的发生可归因于被动吸烟。结论 吸烟是肺癌的重要危险因素,工作环境被动吸烟是男性非吸烟者肺癌的主要危险因素,家庭环境被动吸烟是女性肺癌的主要危险因素。戒烟具有重大的公共卫生学意义。Objective To investigate the association between smoking, passive smoking and lung cancer. Meth- ods A case-control study was conducted. 1 303 newly diagnosed cases with lung cancer and 1 303 healthy control subjects frequency were matched by gender and age. Epidemiologieal data were collected by in-person interviews using a standard questionnaire. Results Smoking was a risk factor of male lung cancer, the adjusted OR was 4. 974 （95% CI： 3. 933 - 6. 291 ）. The risk of male lung cancer was obviously elevated, along with the decrease in the starting age and the increase in cigarettes smoked per day, the duration, pack-year of smoking as well as the depth of inhalation, and all of them met dose-response relationship （ Ptr~.d 〈 0. 001 ）. The risk of lung cancer among aduh men who quitted smoking since more than ten years ago was lower than that of current smokers. The risk of male smokers suffering from lung quamous cell carcinoma was higher than lung adenocarcinoma. Passive smoking was a risk factor of non-smokers lung cancer. The adjusted OR was 1. 912 （95% CI： 1. 486 -2. 460）. Passive smoking working environment was the major risk factor for male non-smokers lung cancer. The adjusted OR was 2. 221 （95% CI： 1. 361 - 3. 625 ）. In contrast, family environment passive smoking was the major risk factor for female lung cancer in non-smokers. The adjusted OR was 1. 804 （95% CI： 1. 270 -2. 562）. A- bout 68.04% male lung cancer could be attributed to smoking, about 26. 51% lung cancer in non-smokers might be attrib- uted to passive smoking. Conclusions Smoking is the main risk factor for lung cancer. Passive smoking in working envi- ronment is the major risk factor for male non-smokers lung cancer, while family environment passive smoking is the major risk factor for female lung cancer. Quitting smoking has major public health significance.

关 键 词：吸烟 烟草烟污染 肺肿瘤 病例对照研究 

分 类 号：R734.2[医药卫生—肿瘤] R181[医药卫生—临床医学]