上海市居民吸烟与癌症及有关疾病十年前瞻性研究

目的探讨上海市民吸烟与癌症及有关疾病的关系。方法８０年代初在上海市区、市郊和郊县开展了居民吸烟状况的横断面调查。至１９９４年年底，市区研究对象随访了１２年，郊区研究对象随访了１１年。本次研究分析了４０岁以上研究对象的随访资料，并用Ｐｏｉｓｏｎ回归模型估计吸烟因素的年龄调整相对危险度及其９５％可信区间。结果市区分析结果表明，男女性吸烟者全死因的相对危险度分别为１．４８、１．６２。而所有癌症死亡的相对危险度男性为２．２０，女性为２．００。相对危险度有统计学意义的癌症部位是肺癌、肝癌、食管癌（男）、胃癌（男）、胰腺癌（男）、膀胱癌（男）。脑血管疾病、慢性支气管炎、肺气肿和肺心病的相对危险度也见显著升高。市郊和郊县的结果与市区类似。我们估计了三个地区吸烟对男性某些疾病的归因危险度（ＰＡＲ），所有死因吸烟的ＰＡＲ（％）三地分别为２０．９、１８．９、１６．３，所有癌症三地吸烟的ＰＡＲ（％）分别为４０．０、３４．５、３４．２，肺癌三地吸烟的ＰＡＲ（％）分别为７１．７、５９．２、６４．７。结论吸烟与一些癌症、慢性阻塞性肺部疾病、肺原性心脏病及脑血管病等的死亡有关

Smoking, related cancers, and other diseases in shanghai: a 10-year prospective study

OBJECTIVE: To explore the relationship between smoking and related diseases among residents of Shanghai. METHODS: A cross-sectional study on current smoking status among 213,800 residents aged 20 yr and over in Shanghai urban, suburb and rural areas was carried out during the early 1980s. The residents in the urban area were followed up for 12 years (1983 - 1994) and those in suburb and rural areas for 11 years (1984 - 1994). A Poisson regression model was used to estimate relative risks RRs of certain diseases for smoking adjusted for age with their 95% confidence intervals by sex and area among persons aged 40 yr and over at the beginning of the study. RESULTS: In the urban area, the RRs of death for smoking were 1.48 and 1.62 in males and females, respectively and for cancer death were 2.20 and 2.00. Statistically significant elevated RRs were seen for cancers of the lung and liver in both males and females and for cancers of the oesophagus, stomach, pancreas and bladder only in males. Significantly higher RRs were also observed for cerebrovascular disease, chronic bronchitis and emphysema, and pulmonary heart disease. RRs lower than in the urban area were found in the suburb and rural areas. The population attributable risks (%, PAR) for death due to smoking for males were estimated by area. PARs for death were 20.9, 18.9 and 16.3 in urban, suburb and rural areas, respectively. For all cancers, PARs were 40.0, 34.5 and 34.2 and for lung cancer were 71.7, 59.2 and 64.7. CONCLUSION: Smoking was associated with the mortality of some common cancers, chronic bronchitis, and emphysema, pulmonary heart, and cerebrovascular diseases.