主动吸烟所致中国人群消化系统恶性肿瘤风险的meta分析  

A meta-analysis of the relationship between active smoking and digestive system cancer in Chinese population

作　　者：王敬鑫 赵健 石钰霖 王宇彤 胡葵茹 艾飞玲 王雪威 杨文怡 艾丽梅 万霞[1] WANG Jingxin;ZHAO Jian;SHI Yulin;WANG Yutong;HU Kuiru;AI Feiling;WANG Xuewei;YANG Wenyi;AI Limei;WAN Xia(Department of Epidemiology and Health Statistics,Institute of Basic Medical Sciences,Chinese Academy of Medical Science&School of Basic Medicine,Peking Union Medical College,Beijing100005,China)

机构地区：[1]中国医学科学院基础医学研究所·北京协和医学院基础学院流行病与卫生统计学系,北京100005

出　　处：《中华肿瘤防治杂志》2023年第9期546-556,共11页Chinese Journal of Cancer Prevention and Treatment

基　　金：中国医学科学院协同创新团队项目(2016-12M-3-001);美国中华医学基金会项目(15-208)。

摘　　要：目的探讨主动吸烟所致中国人群消化系统恶性肿瘤的风险大小,为制定中国控烟政策及评估烟草使用所致中国人群疾病负担提供必要参数。方法在PubMed、Web of science、Embase、CNKI、维普、万方、Sinomed数据库中检索从建库至2021-06-31发表的关于吸烟与消化系统恶性肿瘤关系的文献,主题词包括烟草、吸烟、香烟、吸烟者、抽烟者、尼古丁、队列、病例对照、中国和中国人,使用Stata 16.0进行Meta分析,探究相对风险值(RR)。结果共纳入88篇文献,相比不吸烟者,吸烟、现在吸烟、戒烟者消化系统恶性肿瘤合计的RR(95%CI)分别为1.94(1.77~2.13)、1.95(1.52~2.51)、2.06(1.41~3.02)。吸烟者男性RR(95%CI)为1.42(1.32~1.52),略高于女性的1.30(1.20~1.41);现在吸烟和戒烟者中女性文献仅1篇,且RR无统计学意义,男性均有统计学意义。吸烟者男性食管癌的RR(95%CI)为1.92(1.63~2.25),高于胃癌的1.30(1.19~1.41)、肝癌的1.25(1.14~1.36);女性食管癌的RR(95%CI)为1.50(1.35~1.66),高于胃癌的1.17(0.99~1.28),其余各癌症间差异无统计学意义;现在吸烟和戒烟者中各癌症间比较差异无统计学意义。亚组分析提示吸烟导致消化系统恶性肿瘤合计患病的RR(95%CI)为2.12(1.90~2.36),高于死亡的1.53(1.30~1.79);男性病例对照研究的RR(95%CI)为2.12(1.74~2.57),高于队列研究的1.39(1.25~1.55);其余各亚组间差异无统计学意义。结论吸烟与消化系统恶性肿瘤的风险密切相关,尤其是在男性和食管癌中。由于现在吸烟和戒烟者的文献数目较少,异质性较高,未发现两者之间的显著差异。为减轻消化系统恶性肿瘤造成的疾病负担,应进一步加强控烟相关措施。Objective To explore the association between active smoking and digestive system cancer in Chinese population,and to provide necessary parameters for formulating tobacco control policies and assessing the diseases burden caused by tobacco in China.Methods We searched literatures on the association between smoking and digestive system cancer published in PubMed,Web of Science,Embase,CNKI,VIP,Wanfang and Sinomed databases from database establishment to June 31st,2021.MeSH included tobacco,smoking,cigarette,smoker,smokers,nicotine,case control,cohort,case-control,China,and Chinese.We explored the pooled relative risk value(RR)by using meta-analysis.Results Totally 88articles were included.Compared with never smokers,the RR(95%CI)of total digestive cancer in ever smokers,current smokers and former smokers were 1.94(1.77-2.13),1.95(1.52-2.51)and 2.06(1.41-3.02),respectively.The RR(95%CI)of ever smokers was 1.42(1.32-1.52)in males,which was slightly higher than 1.30(1.20-1.41)in females.In terms of current smokers and former smokers,RR for females was not statistically significant with only one article being searched,while RR was statistically significant for males.The RR(95%CI)of male ever smokers with esophageal cancer was 1.92(1.63-2.25),which was significantly higher than that of gastric cancer 1.30(1.19-1.41),liver cancer 1.25(1.14-1.36).The RR(95%CI)of female ever smokers with esophageal cancer was 1.50(1.35-1.66),which was significantly higher than that of gastric cancer 1.17(0.99-1.28).There was no significant difference among other cancers in ever smokers.There was no significant difference among various cancers in current and former smokers.Subgroup analysis showed that the RR(95%CI)of prevalence of total digestive cancer caused by smoking was 2.12(1.90-2.36),which was significantly higher than that of death 1.53(1.30-1.79).The RR(95%CI)of male case-control study was 2.12(1.74-2.57),which was significantly higher than that of cohort study 1.39(1.25-1.55).There were no significant differences among the other s

关 键 词：中国人群 吸烟 消化系统恶性肿瘤 危险因素 META分析 

分 类 号：R735[医药卫生—肿瘤]