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乳腺癌危险因素综合评价及其趋势预测
引用本文:方亚,施侣元.乳腺癌危险因素综合评价及其趋势预测[J].中华流行病学杂志,2003,24(7):611-614.
作者姓名:方亚  施侣元
作者单位:430030,武汉,华中科技大学同济医学院流行病与卫生统计学系
基金项目:卫生部慢性非传染性疾病预防与控制专题研究基金资助项目 ( 3 1)
摘    要:目的:综合分析评价中国乳腺癌的危险因素并预测其发展趋势。方法:收集近10年来国内有关乳腺癌危险因素的病例对照研究文献,采用Meta分析的随机效应模型,计算有关危险因素的OR值及其95%CI,找出乳腺癌的主要危险因素;结合人群暴露率,估计目前和预测未来的人群归因危险度百分比(PARP);估计暴露率的变化,预测未来5年乳腺癌发病率的变化。结果:共筛选出相关文献22篇。前5位乳腺癌危险因素及OR值(95%CI)依次为:良性乳腺疾病3.39(2.97~3.86)、生活精神刺激2.36(2.09~2.67)、哺乳1.95(1.54~2.47)、肿瘤家族史1.84(1.63~2.08)、月经周期1.65(1.44~1.89);获得较大PARP的因素依次为良性乳腺疾病、哺乳、生活精神刺激,其目前PARP分别为15.47%、15.17%、13.76%,若这些因素5年或10年后的暴露率均下降20个百分点和40个百分点,其PARP分别下降至12.77%、11.32%、12.52%和9.90%、8.74%、9.69%;随着暴露率的改变,乳腺癌的发病率亦将发生改变,其中贡献较大的因素依次是良性乳腺疾病、哺乳、生活精神刺激,如暴露率下降20个百分点和40个百分点,其发病率将分别降低3.09%、2.75%、3.03%和6.19%、5.50%、6.07%。结论:控制中国人群乳腺癌的发生及发展,应从降低良性乳腺疾病、避免生活精神刺激和提倡母乳喂养几个方面积极采取有效措施。

关 键 词:乳腺癌  危险因素  综合评价  趋势预测  流行病学
收稿时间:2002/11/8 0:00:00
修稿时间:2002年11月8日

Comprehensive evaluation and trend prediction of risk factors on breast cancer
Fang Ya and Shi Luyuan.Comprehensive evaluation and trend prediction of risk factors on breast cancer[J].Chinese Journal of Epidemiology,2003,24(7):611-614.
Authors:Fang Ya and Shi Luyuan
Institution:Department of Epidemiology & Health Statistics, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Abstract:Objective To comprehensively analyse and evaluate the risk factors and to predict the trend of breast cancer in China. Methods Collecting the articles on case control studies related to breast cancer in the last 10 years in China. Calculating the relative risk ( OR ) and 95% confidence interval (95% CI ) of risk factors by the random effect model of Meta analysis to estimate present and future population attributable risk percent (PARP) based on the exposure rate of risk factor and to predict the change of incidence rates of breast cancer during the following 5 years with the change of exposure rates. Results Twenty two articles referred to case control studies on breast cancer were selected. The OR and its 95% CI of the first 5 risk factors of breast cancer in China were benign breast lesion 3.39 ( 2.97 3.86 ), psychological stimulation 2.36 ( 2.09 2.67 ), breast feeding 1.95 ( 1.54 2.47 ), family history of tumor 1.84 ( 1.63 2.08 ) and menstruation 1.65 ( 1.44 1.89 ). The factors with higher PRAP were benign breast lesion, breast feeding, psychological stimulation with PRAR 15.47 %, 15.17 %, 13.76 %,respectively. Their PRAP would have decreased to 12.77 %, 11.32 %, 12.52 % and 9.90 %, 8.74 %, 9.69 % respectively if the exposure rates had decreased 20% and 40% in the next 5 or 10 years. Factors contributing to the change of incidence rate of breast cancer would include benign breast lesion, breast feeding, psychological stimulation along with the change of exposure rate.The incidence rates of breast cancer would then have become 3.09 %, 2.75 %, 3.03 % and 6.19 %, 5.50 %, 6.07 % respectively if their exposure rate had decreased 20% and 40% in the next 5 or 10 years. Conclusion Decreasing benign breast lesion, avoiding psychological stimulation, advocating on breast feeding seemed to be the effective measures to control the occurrence and development of breast cancer.
Keywords:Breast neoplasms  Risk factor  Evaluation  Prediction
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