饮用农田边水源水与消化道恶性肿瘤关系的病例对照研究

目的分析农田边饮用水源水是否为农村消化道恶性肿瘤高发的危险因素,为肿瘤防控提供依据。方法应用病例对照研究,以青田、龙泉和缙云3个县（市）2009—2011年报告确诊的180例消化道恶性肿瘤为病例组,按居住乡镇、年龄与性别1∶2配比360名健康人群为对照组,分析饮用农田边水源水对消化道恶性肿瘤致病的影响。结果 3个县（市）调查点的全部病例组饮用农田边水源的暴露比高于对照组（OR=4.005,95%CI为2.228~7.199）,青田县病例组饮用农田边水源水人群的消化道恶性肿瘤发病危险性是饮用非农田边水源水人群的5.375倍（95%CI为2.287~12.635）,而龙泉市和缙云县则未见统计学关联（P〉0.05）。胃癌组暴露农田边水源水比例高于对照组（OR=4.875,95%CI为2.007~11.839）,但肝癌、结直肠癌和食管癌病例组农田边水源水暴露比例与对照组差异均无统计学意义（P〉0.05）。青田县胃癌组病例暴露农田边水源水的比例是对照组的5.750倍（95%CI为1.683~19.649）,其他病种病例组与对照组的暴露比例差异无统计学意义（P〉0.05）。结论农田边饮用水源水可能是农村部分地区胃癌高发的危险因素之一。

A case- control study on the relationship of drinking water from farmland edge and digestive tract cancers

Objective To explore the relationship between drinking water from farmland edge and digestive tract cancers in rural areas. Methods A total of 180 cases of digestive tract cancers from Longquan city,Jinyun county and Qingtian county were selected and 360 controls with the same age group and sex were enrolled. 1∶ 2 matched design of case- control study was used. The data was analyzed by Wilcoxon matched- pairs signed- ranks test. Results Overall,individuals who drank water from farmland edge were more likely to have digestive tract cancer among 3 areas（ OR = 4. 005,95% CI：2. 228- 7. 199）. In Qingtian county the risk of digestive tract cancers in individuals who drank water from farmland edge was 5. 375 times of control group population（ 95% CI： 2. 287- 12. 635）,But there was not statistically significant in Longquan city and Jinyun county（ P〈 0.05）. For gastric cancer,the proportion of drinking farmland edge water was significantly higher in cases than that in control group（ OR = 4. 875,95% CI： 2. 007- 11. 839）,while the difference was not statistically significant for liver cancer,colorectal cancer and esophageal cancer（ P〈 0.05）. In Qingtian county,for gastric cancer,the proportion of drinking water from farmland edge was 5. 750 times of control group population（ 95% CI：1. 683- 19. 649）. But there was not statistically significant in other cancers（ P〈 0.05）. Conclusion Drinking water near farmland edge may be one of the risk factors of gastric cancer in rural areas.