川东北地区40~69岁居民上消化道癌危险因素及其区域聚集关系分析  

Risk Factors and Spatial Clustering of Upper Gastrointestinal Cancers in Residents Aged 40~69 in Northeastern Sichuan

作　　者：王小棠 马艺丹 苟晓英 董娟 龙思泽[3] 田小兵[4] Wang Xiaotang;Ma Yidan;Gou Xiaoying;Dong Juan;Long Size;Tian Xiaobing(Department of Public Health,Langzhong People’s Hospital,Nanchong 637400,Sichuan,China;Department of Gastroenterology,Langzhong People’s Hospital,Nanchong 637400,Sichuan,China;Queen Mary College,Nanchang University,Nanchang 330031,Jiangxi,China;School of Public Health,North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]阆中市人民医院公共卫生科,四川南充637400 [2]南昌大学玛丽女王学院,南昌330031 [3]阆中市人民医院消化科,四川南充637400 [4]川北医学院公共卫生学院,四川南充637000

出　　处：《肿瘤预防与治疗》2025年第2期162-170,共9页Journal of Cancer Control And Treatment

基　　金：南充市医卫领域自筹资金研发项目(编号:22YFZJZC0040)。

摘　　要：目的:分析川东北地区上消化道癌筛查人群发病现状、危险因素及其区域聚集性,为癌症防治工作提供参考依据。方法:数据来自川东北地区4县市(阆中、南部、西充、苍溪)项目点2016~2023年期间的筛查资料,采用Epidata 3.1建立数据库,采用SAS 9.2进行数据分析,采用χ2检验做单因素分析,采用多因素Logistic回归模型分析癌变及癌前病变的相关因素。采用空间流行病学方法,以县(市、区)乡镇为尺度,采用R 4.3.3,计算相对危险度和Moran’s I值,揭示高发和低发地区。结果:本研究共调查65620人,检出阳性病例973例,检出率为1.48%。其中,食管、贲门和胃癌检出率分别为1.18%、0.16%和0.16%,不同特征研究对象差异显示,阆中市、男性、年龄越大、婚姻为其他、教育程度小学及以下、家庭人数6人及以上、BMI<18.5、饮水主要来源除自来水以外、吸烟、饮酒、从不吃新鲜蔬菜、水果、经常吃腌晒、烫热食品的研究对象上消化道癌症及癌前病变患病率较高,差异有统计学意义(P均<0.05)。Logistic结果显示,男性、年龄50~59岁、60~69岁者、饮酒、很少吃新鲜蔬菜、水果者发生上消化道癌及癌前病变的患病风险较高,共识别出25个空间异质性高发病区、36个低发病聚集区及50个非显著区域的乡镇,差异均有统计学意义(P<0.05)。结论:川东北地区40~69岁居民上消化道癌,尤其是食管癌处于较高发病水平,且存在明显的空间聚集性,建议针对高危人群及高发地区,积极采取相应防治措施,以降低疾病负担。Objective:To analyze the onset,risk factors and spatial clustering of upper gastrointestinal cancers in northeastern Sichuan,providing evidence for prevention and control efforts.Methods:Data were collected from screening records in four counties(Langzhong,Nanbu,Xichong and Cangxi)from 2016 to 2023.A database was established using EpiData 3.1,and data analysis was performed using SAS 9.2.Univariate analysis was conducted using the 2 test,while multivariate logistic regression was employed to identify factors associated with cancer and precancerous lesions.Spatial epidemiological methods were utilized,calculating relative risk and Moran’s I values using R 4.3.3 to reveal high and low incidence areas at county and township levels.Results:A total of 65,620 individuals were surveyed,reporting 973 positive cases,with a detection rate of 1.48%.Detection rates for esophageal,cardia and gastric cancers were 1.18%,0.16%and 0.16%,respectively.Higher prevalence rates of upper gastrointestinal cancers and precancerous lesions were observed among respondents from Langzhong County,male respondents,aged respondents,respondents with other marriage,primary school or below respondents,respondents having family number of 6 people and above,respondents with BMI<18.5,respondents drinking non-tap water,smoking respondents,respondents drinking alcohol,respondents never eating fresh vegetables or fruits,and respondents often eating pickled,sunned or hot foods(P<0.05).Results of logistic analysis showed that males,people aged 50~59 and 60~69,people drinking alcohol,people rarely eating fresh vegetables or fruits had an increased risk of upper gastrointestinal cancers and precancerous lesions.A total of 25 spatially heterogeneous high-incidence areas,36 low-incidence clusters and 50 non-significant distribution areas were identified(P<0.05).Conclusion:Residents aged 40~69 in the northeastern Sichuan exhibit a high incidence of upper gastrointestinal cancers,particularly esophageal cancer,with significant spatial clustering.It is recomme

关 键 词：川东北地区 上消化道癌 危险因素 区域聚集 

分 类 号：R735.1[医药卫生—肿瘤] R735.2[医药卫生—临床医学]