河西走廊中部食管癌危险因素调查

 目的　调查分析甘肃省河西走廊中部地区食管癌高发的危险因素，为防治食管癌提供依据。 方法　应用以医院为基础的病例对照调查研究，调查分析了该地区食管癌发病的危险因素。结果　经单因素、多因素及Logistic回归模型分析，发现长期大量饮酒、少食新鲜蔬菜及肉蛋鱼、喜烫热饮食、食管癌家族史、重大精神创伤史及文化程度低等因素与食管癌发病密切相关，是河西走廊地区食管癌发病的主要危险因素。未发现吸烟、常吃酸菜和进食快等因素与食管癌的发生存在联系。结论　经调查发现该地区食管癌发病的危险因素与当地特殊的生活环境因素有关，主要表现在饮食生活习惯及精神因素等方面。这些因素的作用并非独立，而是相互影响、相互作用形成的。     

广东汕头地区食管癌高发区食物中危险因素的研究

目的：旨在调查中国潮汕食管癌高发区一些常见食品如鱼露、酸菜、咸鱼、咸肉、熏制食品、水果以及蔬菜等的食管癌病因学作用。方法：应用病例--对照方法,共调查1248例食管鳞状细胞癌病例及1248例按年龄、性别的对照,采用条件Logistic回归对资料进行统计分析。结果：调整职业、居住地、经济收入、饮酒、吸烟和饮茶等因素后,发现食用鱼露和酸菜有显著的食管癌危险作用,水果对食管癌具有明显的保护效应。食用咸鱼和咸肉的危险度均升高,但剂量-效应关系无统计学显著性。没有发现蔬菜和熏制食品对食管癌有明显致癌效应。结论：进一步提示鱼露和酸菜与人群中的高食管癌危险性相关,但两者间的生物学因果关系需进一步的流行病学和实验研究证实。     

肥城市食管癌的危险因素研究

目的：探讨肥城市食管癌高发的危险因素。方法：采用病例对照研究方法，问卷调查获取资料，分层分析和Logistic回归分析计算统计指标OR。结果：185例患者和204例对照，在调整的因素为年龄，性别，文化水平，吸烟指数，饮酒指数和喝茶指数等因素后，发现食管癌家族史，患有食管病史，吃咸菜多，吃霉变食品，种菜少或不种菜，水源污染为危险因素。对10年前和20年的饮食组成和营养成分分析发现，居民10年前和20年前的大豆及豆制品摄入量对照组是病例组的2倍。将其按所含的营养成分计算后两组比较，20年前蛋白，铁，磷摄入量多有保护性作用，并呈线形相关。不同因素共同暴露分析显示，食管癌家族史与食管病史，吸烟和饮酒有协同作用，蛋白摄入量增加有拮抗作用。结论：本地区食管癌危险因素的特异性发现为水源污染和蛋白摄入量偏低，大豆蛋白可能有保护作用。     

姜堰市食管癌危险因素的病例对照研究

目的：研究姜堰市食管癌的危险因素,为食管癌的预防监测提供依据。方法：1999年8月－2000年6月间采用问卷调查,对156例年龄范围在32－80岁食管癌生存病例,按1：1配对,调查内容包括一般情况、居住环境、生活习惯、饮食嗜好、既往疾病及家族史等方面110个问题。采用相对危险度的近似估计值比值比来估计各危险因素与食管癌的联系强度,用logistic回归模型做单因素和多因素分析,筛选出专业上有意义的食管癌危险因素。结果：与食管癌发病有关的变量4个,分别为喜食烫食物、喜食酸辣食品、饮酒和吸烟。结论：喜食烫食物、喜食酸辣食品,饮酒和吸烟是具有统计学意义的食管癌危险因素。     

饮酒比吸烟更易致食管癌

最近英国和香港地区的科学家对香港4家医院自19Sg年3月至1990年12月期间诊治的400名食管瘤患者，其中63人从不吸烟，53人从不饮酒，并与1598名对照组人员进行对比（54名从不吸烟，407名从不饮酒人烟和酒虽然都与增加生癌危险密切相关，科研人员发现受影响最大的，是在饮酒而不吸烟的小组中。他们说对从不饮酒的人，吸烟与生癌的危险关系甚为密切，但在只饮酒从不吸烟的小组中，这种倾向表现的并不明显。他们的研究还着重指出饮食因素也很关键。认为常吃中国的演酸菜，喜喝过热的场和粥，过少摄人绿色蔬菜及水果，都能增加发生食管癌的危险…     

65例高龄食管癌术后肺部并发症危险因素的多因素分析

[目的]探讨高龄食管癌术后肺部并发症的危险因素及其防治。[方法]采用病例对照研究方法．对2002年1月～2005年6月期间的高龄食管癌手术患者进行调查，并对术后肺部并发症可能的危险因素进行Logistic回归分析。[结果]多因素非条件Logistic逐步回归分析显不：FEV1／FVC〈70％、贫血、吸烟史、术前放疗、手术时间超过4h、吻合口平面在主动脉弓上是食管癌术后肺部并发症的主要危险因素；术后镇痛是保护因素。[结论]对于高龄食管癌患者应做好充分的术前准备，选择合适的术式，术后常规镇痛。     

扬中市1991～1998年食管癌发病率及其危险因素分析

目的 探讨扬中市食管癌发病及治疗特征和致病危险因素，为其综合防治提供依据。方法 收集扬中市1991－1998年食管癌发病、病理、治疗及致病危险因素资料，按《中国恶性肿瘤登记报告试行规范》的统计方法，分析扬中市食管癌高发的流行病学特征及规律。结果 扬中市1991－1998年食管癌标化发病率为82．84／10万，居扬中市恶性肿瘤第二位，男、女性别比小（1．21：1），女性在35－64岁年龄段发病率高于男性，并有明显的地区分布，患者治疗率低，近几年来扬中市仍是全国食管癌高发区之一。结论 扬中市食管癌呈持续高发状态，阻断其致病危险因素继续起作用是综合防治的重点。     

EGF基因rs11568848和rs11568849位点突变型与食管癌的关联研究

摘 要：［目的］ 检测人血液中表皮生长因子EGF基因（epidermal growth factor gene，EGF）rs11568848和rs11568849位点多态性与食管癌的关联。［方法］ 应用病例对照研究，基因多态性分析采用Snapshot法对DNA形态进行测序，数据分析运用SPSS软件进行分析研究因素与食管癌罹患的关联。［结果］rs11568848位点GT基因型、rs11568849位点纯合型突变CC基因型频率分布在病例组和对照组差异有统计学意义（P＜0.001）。携带rs11568848GT杂合突变型是增加食管癌发生的危险因素；rs11568849纯合突变型CC是可能降低食管癌罹患风险的保护因素。［结论］ EGF基因rs11568848位点GT杂合突变型、男性、吸烟、饮酒、文化程度初中以下和具有热烫饮食习惯是罹患食管癌的危险因素；rs11568849位点纯合型突变CC型是降低食管癌罹患风险的保护因素。     

少腌酸菜保平安

我国居民吃酸菜的习惯历史久远，特别是北方寒冷、少雨的地区，新鲜绿菜不多，相当长的时间靠吃腌酸菜度日，家庭自制酸菜已成传统的饮食习惯。然而从太行山区预防食管癌的工作开始，我们发现吃酸菜与食管癌的发生有关；     

姜堰市食管癌危险因素的病例对照研究

目的　研究姜堰市食管癌的危险因素 ,为食管癌的预防监测提供依据。方法　 1 999年 8月～ 2 0 0 0年 6月间采用问卷调查 ,对1 56例年龄范围在 32～ 80岁食管癌生存病例 ,按 1∶1配对 ,调查内容包括一般情况、居住环境、生活习惯、饮食嗜好、既往疾病及家族史等方面 1 1 0个问题。采用相对危险度的近似估计值比值比来估计各危险因素与食管癌的联系强度 ,用logistic回归模型做单因素和多因素分析 ,筛选出专业上有意义的食管癌危险因素。结果　与食管癌发病有关的变量 4个 ,分别为喜食烫食物、喜食酸辣食品、饮酒和吸烟。结论　喜食烫食物、喜食酸辣食品、饮酒和吸烟是具有统计学意义的食管癌危险因素。     

Prognostic factors in invasive cutaneous malignant melanoma: a population-based study and review

A population-based study from Sweden identified 711 patients with cutaneous malignant melanoma diagnosed in 1965, 1975, 1985 and 1989. Prognostic factors were evaluated and a review of the literature was performed. On univariate analysis, thick tumours (> 0.8 mm) (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.6-2.1), increasing Clark level (OR 1.8, 95% CI 1.6-2.0), ulceration (OR 1.8, 95% CI 1.6-2.0), nodular melanoma (OR 1.5, 95% CI 1.3-1.6) and increasing age (continuous variable, P < 0.0001) were associated with a shorter survival. Location on extremities (OR 0.8, 95% CI 0.7-0.9), inflammation (OR 0.8, 95% CI 0.7-0.9) and female gender (OR 0.8, 95% CI 0.8-0.9) were associated with improved survival. On multivariate analysis, thick tumours (> 0.8 mm) (OR 1.5, 95% CI 1.2-1.7) and ulceration (OR 1.4, 95% CI 1.2-1.6) were independently related to a poor prognosis, while location on extremities (OR 0.8, 95% CI 0.7-0.9), inflammation (OR 0.8, 95% CI 0.7-0.9) and female gender (OR 0.8, 95% CI 0.8-1.0) were associated with improved survival. No difference in mean tumour thickness was seen over time, but there was a significant increase in the percentage of thin melanomas (< 0.8 mm) in 1985 (P = 0.01) and 1989 (P = 0.002) compared with 1965. The incidence of melanomas with inflammation increased significantly (P = 0.04), as did age at diagnosis (P = 0.005).     

Mutagenic, transforming and promoting effect of pickled vegetables from Linxian county, China

A recent epidemiological survey in China showed that there is a regional distribution of esophageal cancer and a correlation between mortality for this cancer and environmental factors, especially the consumption of pickled vegetables. A series of experimental studies with pickled vegetable extract were done using different in vitro biological systems. The results showed that pickled vegetable extract induced 6-thioguanine-resistant mutants in V79 cells and increased sister chromatid exchanges in the same cells and in Syrian hamster embryo cells. Pickled vegetables extract induced transformed foci in Syrian hamster embryo cells and in 3-methylcholanthrene initiated C3H/10T1/2 cells. The mutagenic, transforming and promoting activities of pickled vegetable extract seen in vitro conform with in vivo results and provide evidence for the presence of a mutagen and/or a carcinogen in pickled vegetable extract. A possible role of pickled vegetables consumption in the etiology of esophageal cancer is discussed.     

Population-based Case-control Study on Risk Factors for Esophageal Cancer in Five High-risk Areas in China

Objective: To study major etiological factors for esophageal cancer in upper gastrointestinal cancer high riskareas in China. Methods: Five areas with high incidences of esophageal and gastric cancer with good qualitycancer registration data were selected for the study: Cixian, Shexian from Hebei Province, Linxian from HenanProvince, Feicheng from Shandong Province and Zhuanghe from Liaoning Province. A total of 250 cases wererandomly recruited from the cancer registration database diagnosed as arising in the lower esophageal segmentsince January 1, 2009. Three controls were identified and matched with each case as having similar characteristics,such as gender, sex and residency. Questionnaires were applied by face to face interview with trained staff, anddata entry was conducted using EPIDATA software. Conditional logistic models were employed for univariateand multivariate analyses to evaluate odd ratios and 95% confident intervals, with SPSS 13.0 statistic software.Results: In single variable analysis, gastrointestinal history, GERD, smoking, passive smoking, alcohol drinking,hot food, pickled food, overnight vegetable, dried food, no breakfast, false dining posture were found to be riskfactors of esophageal cancer. Eating more fresh vegetables and high BMI were protective factors. Gastrointestinalhistory (OR=12.658), not taking regular meals (3.465), overnight vegetables (OR=3.296), GERD (OR=3.044),hot food (OR=2.510), passive smoking (OR=2.423), pickled food (OR=2.273), alcohol drinking (OR=2.074),seldom eating breakfast(OR=1.987), and false dining posture (OR=1.977) increased the risk of esophageal canceron multivariate logistic analysis, and fresh vegetables (OR=0.279) and BMI≥25 (OR=0.528) continued to beprotective. Conclusions: Esophageal cancer could be caused by genetics acting in synergy with environmentalfactors. Health education for the general population in high risk areas should be strengthened, with interventionprograms of nutrition and lifestyle focusing on effective prevention and control for upper gastrointestinal cancer.     

Dietary factors and risk of colon cancer in Shanghai, China.

Colon cancer incidence rates have risen sharply in Shanghai, China, since the early 1970s, and diet may have contributed to the rising incidence. To clarify the role of dietary factors for colon cancer in Shanghai, we analyzed data from a population-based case-control study of 931 cases (462 males and 469 females) and 1552 controls (851 males and 701 females) ages 30-74 years in Shanghai, China, from 1990-1993. Subjects were interviewed in person for a detailed history of dietary practices and food preferences by using a food-frequency questionnaire. Colon cancer risk was estimated by odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, total energy, and other confounding factors. Risk for the highest versus the lowest quartile of intake was elevated for red meat (OR, 1.5; 95% CI, 1.0-2.1 for men and OR, 1.5; 95% CI, 1.0-2.2 for women), fish (OR, 1.7; 95% CI, 1.2-2.4 for men and OR, 1.2; 95% CI, 0.8-1.7 for women), and eggs (OR, 1.4; 95% CI, 1.0-1.9 for men and OR, 1.3; 95% CI, 0.9-1.9 for women), but was reduced for fresh fruit (OR, 0.7; 95% CI, 0.5-1.0 for men and OR, 0.6, 0.4-0.9 for women). High intake of preserved foods, whether animal or plant source, was associated with an excess risk of colon cancer (OR, 2.0; 95% CI, 1.5-2.9 for men and OR, 2.7; 95% CI, 1.9-3.8 for women). For dietary nutrients, risk generally declined with greater consumption of fiber and micronutrients common in fruit and vegetables, including vitamin C, carotene, and vitamin E. Intake of macronutrients in general was not significantly related to risk. Our findings suggest that diets high in fruit and antioxidant vitamins that are common in plant foods reduce the risk of colon cancer, whereas diets high in red meat, eggs, and preserved foods increase the risk.     

Processed food consumption and risk of esophageal squamous cell carcinoma: A case‐control study in a high risk area

This study was conducted to investigate the association between consumption of processed foods and esophageal cancer risk. A population‐based case‐control study was designed. For the present study, 254 patients with esophageal squamous cell carcinoma with pathological diagnoses were selected from Yanting during 2008 and 2010 and 254 community‐based controls were selected from the same area, individually matched with cases by age and sex. Data on demographic, lifestyle and dietary factors were collected using food frequency questionnaires. A conditional logistic regression model was used to estimate the odds ratio (OR) with adjustments for potential confounders. Compared to the frequency of <1 time/week, the intake frequency of >3 times/week of preserved vegetables had a significant association with esophageal cancer (OR = 5.01, 95% confidence interval [CI] 2.07, 12.17). In stratified analyses, the OR of increasing intake of preserved vegetables for esophageal cancer were 2.02 in men (95% CI 1.18, 3.48), 3.15 in women (95% CI 1.28, 7.75), 2.41 (95% CI 1.45 4.01) in the persons <65 years old and 1.28 (95% CI 0.35, 4.65) in persons ≥65 years old. Consumption of pickled vegetables was not associated significantly with esophageal cancer risk. Intake of salted meat with a frequency of ≥1 time/week meant that the OR increased to 2.57 (95%CI 1.02, 6.43), but no significant trend or association in subgroup analysis was observed. Preserved vegetable consumption was associated with increased risk of esophageal cancer, while no association was found with pickled vegetables.     

Green tea drinking,high tea temperature and esophageal cancer in high‐ and low‐risk areas of Jiangsu Province,China: A population‐based case–control study

Epidemiological studies suggested drinking green tea is inversely associated with esophageal cancer but results remain inconclusive. Moreover, inconsistent observations found high temperature drinks are associated with esophageal cancer. A population‐based case–control study was conducted in a high‐risk area (Dafeng) and a low‐risk area (Ganyu) of esophageal cancer in Jiangsu province China from 2003 to 2007. It aimed to explore green tea drinking and tea temperature with the risk of esophageal cancer, and to compare the difference between different risk regions. Using identical protocols, 1,520 cases and 3,879 healthy controls were recruited as study subjects in 2 regions. Detailed information was collected to assess green tea drinking habits. Unconditional logistic regression was used to obtain OR and 95% CI. Results showed that ever drinking green tea elevated OR in both counties (Dafeng OR = 1.2, 95% CI = 0.9–1.5; Ganyu: OR = 1.9, 95% CI = 1.4–2.4). Drinking tea at high temperature was found to increase cancer risk in both areas (Dafeng: OR = 1.9, 95% CI = 1.2–2.9; Ganyu OR = 3.1 95% CI = 2.2–4.3). However, after further adjustment for tea temperature, ever drinking tea was not related to cancer in either county (Dafeng: OR = 1.0, 95% CI = 0.7–1.3; Ganyu: OR = 1.3, 95% CI = 0.9–1.7). For dose‐response relationships, we observed positive relationship with monthly consumption of tea (p for trend = 0.067) and tea concentration (p for trend = 0.006) after further adjustment for tea temperature. In conclusion, green tea drinking was not inversely associated with esophageal cancer in this study. However, drinking tea at high temperatures significantly increased esophageal cancer risk. There was no obvious difference of green tea drinking between low‐ and high‐risk areas. © 2008 Wiley‐Liss, Inc.     

Dietary protective and risk factors for esophageal and stomach cancers in a low-epidemic area for stomach cancer in Jiangsu Province, China: comparison with those in a high-epidemic area.

Comparative epidemiological studies with ecological and case-control approaches in high- and low-epidemic areas of China have provided us with much evidence with regard to risk and benefit in the environment. To clarify how dietary factors are involved in esophageal and stomach cancer development, we performed a case-control study in a low-epidemic area, and compared the findings with those obtained earlier for a high-epidemic area for stomach cancer in the same Jiangsu Province, China. We recruited 199 and 187 cases with esophageal and stomach cancers, respectively, and 333 population-based common controls. Odds ratios (ORs) for esophageal and stomach cancers were calculated with adjustment for potential confounding factors, using an unconditional logistic model. Current and former smoking elevated the OR for esophageal cancer, along with high intake of pickled vegetables and broiled meat, while decreased ORs were observed for frequently consumed raw vegetables and garlic. With regard to stomach cancer, ORs were increased with frequent consumption of salty fish, leftover gruel, and broiled meat, and lowered by snap bean consumption. The present risk factors were common to the previously obtained results in the high-epidemic area, and similarly distributed in each general population. While more protective factors were observed in the high-epidemic area, their penetrance was much greater in the low-epidemic area. The present study thus suggests that frequent vegetable and garlic consumption contributes to low mortality rates for esophageal and stomach cancers in a low-epidemic area, counteracting similar exposure levels for risk factors as in the high-epidemic area.     

Dietary Protective and Risk Factors for Esophageal and Stomach Cancers in a Low-epidemic Area for Stomach Cancer in Jiangsu Province, China: Comparison with Those in a High-epidemic Area

Comparative epidemiological studies with ecological and case-control approaches in high- and low-epidemic areas of China have provided us with much evidence with regard to risk and benefit in the environment. To clarify how dietary factors are involved in esophageal and stomach cancer development, we performed a case-control study in a low-epidemic area, and compared the findings with those obtained earlier for a high-epidemic area for stomach cancer in the same Jiangsu Province, China. We recruited 199 and 187 cases with esophageal and stomach cancers, respectively, and 333 population-based common controls. Odds ratios (ORs) for esophageal and stomach cancers were calculated with adjustment for potential confounding factors, using an unconditional logistic model. Current and former smoking elevated the OR for esophageal cancer, along with high intake of pickled vegetables and broiled meat, while decreased ORs were observed for frequently consumed raw vegetables and garlic. With regard to stomach cancer, ORs were increased with frequent consumption of salty fish, leftover gruel, and broiled meat, and lowered by snap bean consumption. The present risk factors were common to the previously obtained results in the high-epidemic area, and similarly distributed in each general population. While more protective factors were observed in the high-epidemic area, their penetrance was much greater in the low-epidemic area. The present study thus suggests that frequent vegetable and garlic consumption contributes to low mortality rates for esophageal and stomach cancers in a low-epidemic area, counteracting similar exposure levels for risk factors as in the high-epidemic area
.     

Tobacco use and prostate cancer in Blacks and Whites in the United States

Prostate cancer occurs more frequently in Blacks than Whites in the United States. A population-based case-control study which investigated the association between tobacco use and prostate cancer risk was carried out among 981 pathologically confirmed cases (479 Blacks, 502 Whites) of prostate cancer, diagnosed between 1 August 1986 and 30 April 1989, and 1,315 controls (594 Blacks, 721 Whites). Study subjects, aged 40 to 79 years, resided in Atlanta (GA), Detroit (MI), and 10 counties in New Jersey, geographic areas covered by three, population-based, cancer registries. No excesses in risk for prostate cancer were seen for former cigarette smokers, in Blacks (odds ratio [OR]=1.1, 95 percent confidence interval [CI]=0.7–1.5) and in Whites (OR=1.2, CI=0.9–1.6), or for current cigarette smokers, in Blacks (OR=1.0, CI=0.7–1.4) and in Whites (OR=1.2, CI=0.8–1.7). Increases in risk were noted for smokers of 40 or more cigarettes per day, among former (OR=1.4, CI=1.0–1.5) and current (OR=1.5, CI=1.0–2.4) smokers. Duration of cigarette use and cumulative amount of cigarette use (pack-years) were not associated with prostate cancer risk for Blacks or Whites. By age, only the youngest subjects, aged 40 to 59 years, showed excess risk associated with current (OR=1.5, CI=1.0–2.3) and former (OR=1.7, CI=1.1–2.6) use of cigarettes, but there were no consistent patterns in this group according to amount or duration of smoking. Risks also were not elevated for former or current users of pipes, cigars, or chewing tobacco, but the risk associated with current snuff use was OR=5.5 (CI=1.2–26.2). This subgroup finding may have been due to chance. The results of the present study may be consistent with a small excess risk for prostate cancer associated with tobacco use, but the lack of consistent findings in population subgroups and the lack of a clear dose-response relationship argue more strongly that no causal association exists. The data do not indicate that the Black-White difference in prostate cancer risk is related to tobacco use.This research was performed under contracts: NO1-CP-51090, NO1-CN-0522, NO1-CP-51089, NO1-CN-31022, NO1-CP-51092, and NO1-CN-5227.     

Family history of cancer, its combination with smoking and drinking, and risk of squamous cell carcinoma of the esophagus.

We analyzed the association between history of cancer in first-degree relatives and the risk of squamous cell carcinoma of the esophagus (SCCE) using data from three case-control studies conducted in Italy and Switzerland on 805 incident, histologically confirmed SCCE, and 3,461 hospital controls. The alcohol- and tobacco-adjusted odds ratio (OR) for a family history of esophageal cancer was 3.2 [95% confidence interval (CI), 1.7-6.2], and the OR was higher when the affected relative was a brother or was diagnosed at age <55 years. Compared to subjects without family history of esophageal cancer, non-current smokers, drinking <49 drinks per week, the OR was 2.9 (95% CI, 1.1-7.5) for family history alone, 15.5 (95% CI, 11.7-20.5) for current smokers drinking > or = 49 drinks per week without family history of esophageal cancer, and 107.0 (95% CI, 13.0-880.2) for current smokers drinking > or = 49 drinks per week who also had a family history of esophageal cancer. The risk of SCCE was also increased in subjects with a family history of cancer of the oral cavity/pharynx (OR, 3.7; 95% CI, 1.5-9.0) and stomach (OR, 2.0; 95% CI, 1.1-3.6), but not of other cancers, nor for a family history of any cancer (OR, 1.0; 95% CI, 0.8-1.4). These data show that, as for many other epithelial cancers, the risk of SCCE is increased in subjects with a family history of the disease, and that--in Western countries--avoidance of alcohol and tobacco is also the best way to prevent SCCE in subjects with a family history of the disease.