阑尾炎史与结直肠癌发病关系的研究

目的研究阑尾炎与结直肠癌发病之间的关系.方法以1989年5月至1990年4月期间,参加浙江省嘉善县大肠癌筛查的10个乡镇30岁及以上人口为研究队列,按是否具有阑尾炎史分为暴露组和非暴露组,随访从1990年5月至2001年1月,应用回顾性队列研究的方法,对结直肠癌发病率进行分析,并作相对危险度(RR)估计.结果 Poisson回归分析表明,经控制年龄因素后,阑尾炎史仅在女性结肠癌中表现出有统计学意义(P＜0.05),有阑尾炎史者结肠癌的发病风险较之无阑尾炎史者高达近2倍,RR为1.9335,95%可信限为1.0456～3.5754.结论阑尾炎史与结肠癌的发病有关,阑尾炎史是结肠癌的重要危险因子.     

身体测量指标与男性结直肠癌发病关系的前瞻性队列研究

目的 研究我国男性身体测量指标与结直肠癌发病之间的关系。 方法 2006年5月建立开滦集团动态队列,于2006-2014年间,每两年对队列中男性人群进行随访,收集身体测量指标及结直肠癌发病结局资料。同时检索开滦附属医院医疗信息系统、开滦集团保险系统、唐山市医疗保险系统,补充收集随访过程中可能遗漏的结直肠癌新发病例。所有基线身体测量指标均按照四分位法进行分组,并以第一分位为参比组,采用Cox风险比例回归模型分析身高、体重、BMI、腰围、腰围身高比（WHtR）等身体测量指标与男性结直肠癌发病风险的关联,计算发病 HR和95 %CI,并对各测量指标进行线性趋势分析。 结果 共有106 786名男性被纳入研究,共随访747 337.60人年,中位随访时间为7.90年,共收集结直肠癌新发病例318例。调整年龄、教育水平、吸烟、饮酒、每天坐位时间、粉尘暴露史等混杂因素后,与腰围<82.0 cm、WHtR<0.48人群相比,高腰围（≥94.0 cm）与高WHtR（≥0.55）人群结直肠癌发病 HR（95% CI）值分别为1.45（1.05~2.02）和1.66（1.15~2.41）。按发病部位分层分析后发现,与BMI<22.06 kg/m ²、腰围<82.0 cm、WHtR<0.48男性人群相比,BMI≥26.27 kg/m ²、腰围≥94.0 cm和WHtR≥0.55男性人群患结肠癌的 HR（95 %CI）值分别为2.18(1.27~3.73)、2.20（1.27~3.78）和2.42（1.29~4.56）。线性趋势分析显示,WHtR每增加0.1,结肠癌发病风险 HR（95 %CI）值为1.59（1.24~2.02）。 结论 肥胖与男性结直肠癌发生密切相关,合理控制体重可能是预防和控制男性结直肠癌的有效措施之一。     

浙江省嘉善县人群结直肠癌发病与有机氯污染的关系

目的 探讨有机氯污染与结直肠癌发病的关系。方法 采用分阶段整群随机抽样的方法,按结直肠癌标化发病率高低在嘉善县抽取11个乡镇,再随机抽取行政村、自然村,采集各自然村的大米和稻田土壤样品,测定其中各有机氯指标的含量,结合各乡镇的结直肠癌发病资料,用Spearman等级相关进行统计分析。结果 大米和土壤中农药六六六(六氯环己烷,HCH)、滴滴涕(二氯二苯三氯乙烷,DDT)含量均未超过国家标准。各乡镇的结直肠癌标化发病率、各乡镇大米中的δ-HCH、γ-HCH、五氯酚钠以及土壤中δ-HCH含量差异存在显著性;结直肠癌标化发病率与大米中总DDT含量、直肠癌标化发病率与大米中总DDT、1,1-双(对-氯苯基)二氯乙烯(PP’-DDE)含量、结肠癌标化发病率与大米中多氯联苯(PCB_s)的1245组分含量之间存在统计学上的显著相关关系,相关系数分别为0.636、0.691、0.716、0.658,P值均<0.05。结论 直肠癌与有机氯农药(主要是大米中总DDT、PP’-DDE)含量存在统计学上显著的相关关系,而结肠癌与大米中PCB_s的1245组分含量存在显著相关关系。但作为生态学研究,其结论还有待于进一步的确证。     

中国成年人排便频率与结直肠癌发病风险的前瞻性关联分析

目的 分析排便频率与结直肠癌发病风险的前瞻性关联。方法 研究对象来自于中国慢性病前瞻性研究,基线调查开展的时间为2004年6月至2008年7月,在剔除基线时自报患有恶性肿瘤的个体后,最终有510 134人纳入分析。本研究使用的随访数据截止到2016年12月31日,采用Cox比例风险回归模型计算排便频率和结直肠癌发病的关联。结果 研究对象平均随访9.9年,随访期间3 056人发生结直肠癌;在分癌种分析时,纳入结肠癌1 548例,直肠癌1 475例。控制潜在混杂因素后,与排便频率基本1次/d者相比,排便频率>1次/d者发生结直肠癌、结肠癌和直肠癌的HR值分别为1.24（95% CI：1.12~1.39）、1.12（95% CI：0.95~1.31）和1.37（95% CI：1.18~1.59）。按随访时间进行亚组分析,随访前5年对应的HR值分别为1.59（95% CI：1.36~1.86）、1.43（95% CI：1.14~1.80）和1.76（95% CI：1.41~2.19）;随访5年后,上述关联均无统计学意义（交互P<0.05）。与排便频率基本1次/d者相比,排便频率更低者的发病风险无统计学意义。结论 排便频率>1次/d者在随访前5年发生结直肠癌的风险升高。异常增加的排便频率作为一个容易识别的症状,应该在自我健康管理和结直肠癌早期筛检的实践工作中加以重视。     

非甾体类抗炎药对肠息肉及结、直肠癌保护作用的病例对照研究

目的　研究非甾体类抗炎药 (NSAIDs)对肠息肉、结肠癌及直肠癌的保护作用。方法　将 2 0 0 0年 5月至 2 0 0 1年 7月来医院进行结肠镜检查的病人中诊断为结肠癌 (10 5例 )、直肠癌 (14 2例 )及结直肠息肉 (37例 )的患者设为病例组 ,肠炎及未见异常者为对照组 (6 6例 )。对病例组和对照组采用会晤调查的方法回顾过去服用NSAIDs史 ,同时调查其家族史、生活行为及日常饮食情况。采用Egert软件进行logistic回归分析。结果　单因素分析结果表明 ,NSAIDs对肠息肉、结肠癌及直肠癌有明显的保护作用 ,经多变量logistic回归分析其保护作用增强 ,OR值分别 0 2 1(95 %CI为 0 0 7～ 0 6 5 ,P =0 0 0 7)、0 13(95 %CI为 0 0 5～ 0 35 ,P <0 0 0 1)及 0 15 (95 %CI为 0 11～ 0 5 8,P <0 0 0 1)。阿司匹林单因素分析结果表明 ,阿司匹林对肠息肉也有明显的保护作用。logistic回归分析结果显示 ,在控制其他因素的条件下 ,阿司匹林的保护作用加强 ,OR值分别为 0 2 7(95 %CI为 0 0 7～ 0 96 ,P =0 0 4 4 )、0 10 (95 %CI为 0 0 3～ 0 35 ,P <0 0 0 1)、0 ,15 (95 %CI为 0 0 4～ 0 4 9,P =0 0 0 2 )。对布洛芬单独分析结果表明 ,布洛芬对结肠癌和直肠癌均有明显的保护作用 ,但logistic回归分析结果显     

肠镜检查对结直肠癌发病风险影响的前瞻性评价研究

目的:评价肠镜检查对人群结直肠癌发病风险的影响。方法:基于浙江省嘉善县结直肠癌早诊早治筛查项目,以2007年1月至2015年12月初筛阳性需要进一步接受肠镜检查的人群为研究对象,分析中剔除基线信息不完整者、参加筛查前已患结直肠癌者和基线时发现的结直肠癌、肠炎或肠道溃疡患者,最终纳入25 894例。使用Cox比例风险回归...     

腺瘤息肉与结直肠癌

大肠腺瘤息肉是一组良性肿瘤性病变。多项研究提示80％以上的结直肠癌是由腺瘤演变而来。因此，颇为学术界所重视。当前，有关腺瘤及其与结直肠癌关系的研究已不断深入。     

不同饮水类型与结直肠癌发病率的流行病学研究

目的 探索不同饮水类型与结直肠癌发病率之间的关系。方法 随机抽取了浙江省海宁市的８个乡镇为研究区,应用回顾前瞻性研究方法,分别对不同饮水类型的结肠、直肠癌发病率进行分析并作相对危险度（ＲＲ）估计。结果 饮用井水、自来水、河水和池塘水者的结直肠癌发病率男性分别为３．１９／１０万、７．９９／１０万、４５．０６／１０万和１２６．０４／１０万;女性分别为３．０６／１０万、５．１７／１０万、６３．４３／１０     

1994—2019年中国结直肠癌发病趋势与年龄-时期-队列模型分析

目的 了解1994—2019年中国人群结直肠癌（CRC）发病率的变化趋势,探讨年龄、时期、出生队列对CRC发病的影响程度。方法 通过全球疾病负担（GBD）2019数据库获取1994—2019年中国男性与女性CRC发病的相关数据,利用描述性分析与Joinpoint回归模型评价不同性别人群的CRC发病率变化趋势,采用网络分析工具（age-period-cohort analysis tool）比较不同年龄组发病率的流行特征,并采用Stata 15.1基于年龄-时期-队列模型和内生因子法估算CRC发病的年龄效应、时期效应、队列效应。结果 中国男性与女性CRC标化发病率分别从1994年的14.68/10万、11.56/10万增长至2019年的41.43/10万、21.10/10万,其中男性发病率的平均年度变化百分比（4.28%）高于女性（2.50%）,有统计学意义（平行性检验P<0.01,一致性检验P<0.01）。在年龄方面,30～39岁男性CRC发病率增长速度高于男性总体平均水平,而65～79岁男性发病率增长速度低于男性总体平均水平;30～44岁女性CRC发病率增长速度低于女性总...     

上海市区居民1973-2005年结直肠癌发病趋势分析

目的 了解1973-2005年上海市区居民结直肠癌发病率的时间变化趋势.方法 结直肠癌发病资料来自上海市肿瘤发病登记处,共采集32 962例结肠癌患者资料和24 662例直肠癌患者资料.根据人口普查资料中性别、年龄构成估算各年人口数,利用世界标准人口,采用直接法计算标化发病率.标化发病率年度变化百分比(APC)估算采用对数线性回归法,并用病例数进行加权.结果 1973-2005年男女性结直肠癌发病率均呈上升趋势,结肠癌的标化发病率分别从6.09/10万和5.70/10万上升至14.70/10万和14.35/10万,APC分别为3.03%(t=14.77,P<0.01)和3.21%(t=22.15,P<0.01).男女性直肠癌标化发病率分别从7.68/10万和6.51/10万上升至11.45/10万和8.28/10万,APC分别为1.34%(t=7.28,P<0.01)和0.93%(t=7.34,P<0.01).女性结直肠癌的APC在85岁～组达到最高,分别为5.86%和2.79%;而男性在80岁～组APC最高,分别为4.64%和2.38%.男女性45岁及以上各年龄组结肠癌的APC大于直肠癌.33年间,男女性结直肠癌的平均发病年龄由57～60岁推迟到66～70岁.结肠癌发病年龄较直肠癌略晚[2003-2005年,男性结肠癌平均发病年龄为(68.61±12.17)岁,男性直肠癌为(66.81±12.62)岁,t=4.90,P<0.01;女性结肠癌为(69.20±12.13)岁,女性直肠癌为(67.75±12.54)岁,t=3.81,P<0.01].结论 上海市区男女性结直肠癌的标化发病率在33年里稳步上升,其中结肠癌上升趋势更加明显,有必要进一步探讨导致这种变化的原因.     

饮用农田果园周边水源水与消化道恶性肿瘤关系的回顾性队列研究

目的 研究饮用农田果园周边水源水与消化道恶性肿瘤发病的关系.方法 应用回顾性队列研究比较饮用农田周边水源水与饮用非农田周边水人群的消化道恶性肿瘤发病率,分析恶性肿瘤的发生与饮用水水源的关系.结果 饮用农田果园周边水人群的消化道恶性肿瘤的标准化累积发病率（293.62/10万）高于非暴露人群（69.39/10万）（P＜0.01）.暴露组与对照组其他恶性肿瘤的发病率比较差异无统计学意义（P＞0.05）.结论 以农田果园周边水为饮用水是消化道恶性肿瘤高发的危险因素.     

婴幼儿血铅水平与出生前后铅暴露关系的队列研究

[目的]了解婴幼儿血铅水平与出生前后铅暴露的关系,为防治和减轻铅暴露对婴幼儿的不利影响提供科学依据。[方法]采用前瞻性队列研究的方法,在环境铅污染区建立新婚夫妇研究队列,分别在女方怀孕前、孕中期、分娩时以及子代婴幼儿期采集血样,并用石墨炉原子吸收法测定血铅水平;纵向分析出生前后铅暴露对婴幼儿血铅水平的影响。[结果]基线血铅明显高于孕中血铅和脐带血铅,且孕中血铅、脐带血铅与基线血铅高度相关(P<0.01);婴幼儿血铅要明显高于母亲基线血铅、孕中血铅和脐带血铅(P<0.01),且婴幼儿血铅与母亲基线血和脐带血血铅均呈正相关,但差异均无显著性(P>0.05)。[结论]婴幼儿血铅水平与出生前宫内暴露和出生后环境暴露均有关,但与后者关系可能更密切。     

Cancer Incidence among a Cohort of Female Farm Residents in New York State

A retrospective cohort study of cancer incidence among 6,310 female farm residents who were New York Farm Bureau members, or members' spouses or relatives, was conducted from 1980 through 1993. Similar to the previous findings for New York State male farmers, the female farm resident cohort experienced significantly lower cancer rates for all cancers combined, and for lung cancer, compared with rural nonfarm female residents. In addition, significantly low rates for colorectal cancer and ovarian cancer were found among the female cohort members. Nonsignificant excesses were found for thyroid and liver cancers. The findings suggest that female farm residents in this cohort might have experienced some of the same cancer-protective factors as male farmers.     

A prospective study on the association between hay fever among children and incidence of asthma in East Germany

Background Aim of this study was to examine the effect of hay fever in childhood for asthma onset from childhood to adulthood in a prospective cohort of 3,199 asthma-free children, initially aged 5–13 years, which were followed for up to 12 years in East-Germany. Methods Crude and adjusted incidence rate ratios (IRR) of asthma onset due to hay fever at baseline were calculated by a generalized estimation equation approach accounting for person years at risk, age at study entry, parental asthma, and gender. Results Overall 142 incident cases of asthma were observed. Prevalence of hay fever at baseline was 4%. Crude and adjusted IRR were essentially the same and showed overall and in each age group a substantial higher risk of asthma onset due to hay fever. The adjusted IRR was 4 overall and ranged between 3 and 5 within the three age groups. Restricting the analysis to those participants, who were 17–25 years of age at the end of follow-up resulted in similar IRR. Conclusion Hay fever in childhood is a strong predictor of asthma onset later in life up to adulthood. The preventive potential of early and efficient treatment of allergic rhinitis to avoid asthma development needs to be investigated.     

Perspectives on colorectal cancer screening: a focus group study

Objective To assess attitudes and acceptability of Ontario consumers and doctors towards colorectal screening with faecal occult blood testing (FOBT) and colonoscopy. Design, setting and participants Focus groups with gender‐specific samples of the population, high‐risk gastroenterology patients and family doctors. Method Semi‐structured interview guides used by facilitator to lead groups through knowledge of risk factors and prevention of colorectal cancer, the screening modalities, requirements for implementing screening programmes, barriers to screening and preferences towards screening. Main findings There were low levels of knowledge about colorectal cancer and its prevention in the general population. FOBT was an acceptable screening modality, but considerable education about its use and benefits would be necessary to implement a screening programme. Colonoscopy was not perceived to be a good choice for a primary screen in the general population. The high‐risk group supported use of FOBT in the general population and emphasized the need for education. The doctors were more reluctant about screening, requesting clear guidelines. They also identified the time and resources that would be required if a screening programme were initiated. Conclusion While colorectal screening is acceptable in this sample, information and decision aids are required to enable consumers and providers to make effective decisions. Implementation of colorectal screening programmes requires substantial educational efforts for both consumers and doctors.     

Cohort study on the association between alcohol consumption and the risk of colorectal cancer in the Korean elderly]

OBJECTIVES: We examined the association between alcohol consumption and incidence of colorectal cancer in elderly Koreans. METHODS: The cohort members (n=14,304) consisted of 4,834 males and 9,470 females derived from the Korea Elderly Pharmacoepidemiologic Cohort (KEPEC), a population-based dynamic cohort. They were aged 65 years old or older and lived in Busan between 1993-1998; they were beneficiaries of the Korean Medical Insurance Corporation (KMIC). Baseline information was surveyed by a self-administered, mailed questionnaire. This study population was restricted to 14,304 participants who reported alcohol drinking habits on the questionnaire and had not been diagnosed with colorectal cancer at baseline. The adjusted hazard ratios (aHR) of status, type, frequency and daily average amount of alcohol consumption were computed with Cox's proportional hazard model, with the never-drinkers as a reference group and controlling for age and gender. RESULTS: After 4.82 person-years of mean follow-up 112 cases of colorectal cancer occurred. The incidence densities of colorectal cancer were 161 (95% CI=123-200) for never-drinkers, 219 (95% CI=125-339) for ex-drinkers, and 137 (95% CI=84-189) for current-drinkers per 100,000 person-year. The status, type, frequency, and daily average amount of alcohol consumption were not significantly related to the incidence of colorectal cancer after controlling for age and gender. CONCLUSIONS: There was no significant association between alcohol consumption and colorectal cancer among elderly people after controlling for age and gender.     

铅暴露对婴幼儿发育商数影响的队列研究

目的 了解婴幼儿出生前后铅暴露对其智力发育的影响。方法 采用前瞻性队列研究的方法。建立新婚夫妇研究队列，进行基线调查、孕前观察、孕期随访、分娩及新生儿情况记录，及子代发育商数测定和跟踪问卷调查；并用石墨炉原子吸收法测定基线血、孕中血、脐带血和婴幼儿血铅水平；纵向分析出生前后铅暴露水平对婴幼儿智力发育的影响。结果婴幼儿适应性行为能区发育商在父亲基线血铅高、低2组间，语言和个人-社交行为能区发育商数在婴幼儿血铅高低2组间差异有统计学意义。相关分析显示不同血样的血铅水平与婴幼儿5个行为能区发育商数均呈负相关，逐步回归分析显示，婴幼儿每个行为能区发育商数均与不同个体的血铅水平有关。结论 环境铅暴露可能导致婴幼儿智力发育迟缓，且不同行为能区发育的损伤程度与出生前后不同时期的暴露有关，防治铅对儿童的危害应在出生前就开始。     

Cancer incidence among alachlor manufacturing workers

A historical cohort study was conducted to evaluate cancer incidence among chemical workers with occupational and environmental exposure to alachlor, the active ingredient in a family of pre-emergent acetanilide herbicides. The study followed 943 workers with at least 1 year of cumulative employment at the Monsanto plant in Muscatine. Iowa, from startup of the alachlor manufacturing process in March 1968 through December 1990. Approximately 96% of all workers were successfully traced to determine their last known residence and cancer status. Eighteen workers were diagnosed with cancer during the follow-up period, based on pathology information from the statewide cancer registry maintained by the State Health Registry of Iowa. The standardized incidence ratio for all cancers was 1.5 (95% CI 0.9–2.4) for all workers exposed to alachlor, which was due primarily to elevated rates for colorectal cancer and chronic myeloid leukemia. Workers with 5 or more years in estimated high alachlor exposure jobs had elevated rates of colorectal cancer (3 cases, SIR = 5.2, 95% CI 1.1–15.1). Interpretation of the study results is limited by the small size of the study population, minimal length of follow-up, and current information concerning alachlor metabolism in primates and humans. Nonetheless, the findings suggest the need for continued evaluation of this and other alachlor-exposed cohorts. © 1996 Wiley-Liss, Inc.     

萧山区大肠癌发病危险因素的病例对照研究

目的：探讨萧山区人群大肠癌发生的危险因素。方法：采用以医院和社区为基础的1∶2病例对照研究方法,对102例经过病理学确诊的大肠癌患者及204例对照的相关资料进行条件Logistic回归分析。结果：大肠癌的危险因素有红肉和腌制食物（腌肉、咸鱼）食用频率,情绪自我调节能力差,下消化道疾病史,肿瘤家族史。其OR值及95%CI分别为4.99（2.14-11.65）、3.71（1.27-10.88）、2.60（1.03-6.56）、4.66（1.65-13.16）、3.30（1.43-7.62）;保护因素有白肉、新鲜水产类、新鲜蔬菜类食用频率,体育锻炼,OR值分别为0.09（0.03-2.22）,0.30（0.14-0.66）,0.21（0.09-0.49）,0.16（0.03-0.80）。结论：大肠癌的发生与饮食因素、性格特征、下消化道疾病和肿瘤家族史密切相关。     

血脂异常与非酒精性脂肪肝发病关系前瞻性队列研究

目的 了解血脂异常与非酒精性脂肪肝(NAFLD)发病的关系,为NAFLD的预防控制提供参考依据.方法 采取前瞻性队列研究,于2014年1-12月采用方便抽样方法在天津市第一中心医院健康管理科抽取2658名非NAFLD体检者进行随访调查,分析血脂异常与NAFLD发病的关系.结果 2 658名非NAFLD体检者在4年中共发...