中国癌症杂志 ›› 2021, Vol. 31 ›› Issue (4): 335-343.doi: 10.19401/j.cnki.1007-3639.2021.04.014

• 论著 • 上一篇    下一篇

控烟是预防肺癌的主要措施——记太原市肺癌病例对照流行病学调查

穆丽娜 1 ,苏 佳 1 ,俞顺章 1 ,牛润桂 2 ,韩小友 2 ,刘 力 3 ,史建平 3 ,张作风 4   

  1. 1. 复旦大学预防医学研究所,上海 200032 ;
    2. 太原市肿瘤医院医务科,山西 太原 030013 ;
    3. 太原市疾病预防控制中心公共卫生科,山西 太原 030012 ;
    4. 加利福尼亚大学洛杉矶分校公共卫生学院, 加利福尼亚 洛杉矶 90095
  • 出版日期:2021-04-30 发布日期:2021-04-29
  • 通信作者: 俞顺章 E-mail: szyu@shmu.edu.cn

The control of lung cancer relating to quitting active smoking and secondary smoking: a case-control study of lung cancer in Taiyuan

MU Lina 1 , SU Jia 1 , YU Shunzhang 1 , NIU Rungui 2 , HAN Xiaoyou 2 , LIU Li 3 , SHI Jianping 3 , ZHANG Zuofeng 4    

  1. 1. Institute of Preventive Medicine, Fudan University, Shanghai 200032, China; 2. The Medical Department, Taiyuan Cancer Hospital, Taiyuan 030013, Shanxi Province, China; 3. Department of Public Health, Taiyuan Center for Disease Control and Prevention, Taiyuan 030012, Shanxi Province, China; 4. UCLA School of Public Health, Los Angeles 90095, California, USA

  • Published:2021-04-30 Online:2021-04-29
  • Contact: YU Shunzhang E-mail: szyu@shmu.edu.cn

摘要: 背景与目的:山西省太原市空气污染常较为严重。了解各种类型肺癌的危险因素,以采取有效的预防措施。方法:2005年3月—2007年9月,山西省太原市396例肺癌新发病例和465名健康对照者纳入本研究。利用太原市肿瘤医院病理学检查确诊的肺癌病例,配以人群为基础、随机选择的对照,进行病例对照询问调查和环境监测。分析时注意排除病例对照危险因素以外的危险因素并加以平衡,同时进行趋势检验;采用多因素非条件logistic回归分析法,分析各种危险因素,包括比值比(odds ratio,OR)及95%可信区间(95% confidence interval,95% CI)。结果:吸烟与肺癌密切相关。吸烟者发生肺癌危险度比不吸烟者显著升高(OR=3.75,95% CI:2.39~5.89),特别是肺鳞癌和小细胞肺癌(OR=5.01和5.06)。肺癌与吸烟量、吸烟年数、吸烟深度均有显著的剂量效应关系。被动吸烟或长期在厨房使用固体燃料烹饪、取暖等亦对肺癌的发生、发展起着重要作用。PM2.5的研究刚刚开始,尚未发现室内颗粒物的污染与肺癌的发生明显相关。论:太原市居民吸烟仍是肺癌的主要危险因素。被动吸烟、固体燃料烹饪也不容忽视。

关键词: 吸烟, 肺癌, 被动吸烟, 空气污染

Abstract: Background and purpose: Taiyuan City of Shanxi Province is one of the cities in China with serious air pollution. This study aimed to understand the risk factors of various types of lung cancer in order to take effective preventive measures. Methods: From March 2005 to September 2007, 396 lung cancer patients from Taiyuan Cancer Hospital and 465 healthy control persons were included in this study. The lung cancer cases diagnosed by pathology in Taiyuan Cancer Hospital were matched randomly selected population-based controls to carry out case-control investigation and environmental monitoring. During the analysis, the risk factors other than case-control risk factors were excluded and balanced, and the trend test was carried out at the same time; multivariate unconditional logistic regression analysis was used to analyze various risk factors, including odds ratio (OR) and 95% confidence interval (95% CI). Results: The results showed smoking was closely related to lung cancer. The risk of lung cancer in smokers was significantly higher than that in non-smokers (OR=3.75, 95% CI: 2.39-5.89), especially in lung squamous cell carcinoma and small cell lung cancer (OR=5.01 and 5.06). There was a significant dose-effect relationship between lung cancer and smoking amount, smoking years and smoking depth. Passive smoking, or long-term use of solid fuel in kitchen for cooking and heating also played an important role in the occurrence and development of lung cancer. The research of PM2.5 has just begun, and no significant correlation between indoor particulate matter pollution and lung cancer has been found. Conclusion: Smoking is still an important risk factor for lung cancer in Taiyuan City. Passive smoking and solid fuel cooking should not be ignored.

Key words:  Smoking, Lung cancer, Passive smoking, Air pollution