慢性肺部疾病与肺癌发病风险关联的孟德尔随机化研究

目的探讨既往患有慢性肺部疾病与肺癌发病风险的关联情况。方法采用英国生物银行(UKB)调查数据, 以既往未被诊断为癌症且自报性别与遗传性别一致的472 397名参与者为研究对象。采用基线问卷和国家健康系统数据收集既往慢性肺部疾病患病情况、一般人口学特征以及肺癌患病情况等信息。采用多因素Cox比例风险回归模型分析哮喘、慢性阻塞性肺病、特发性肺纤维化、间质性肺病等4种既往慢性肺部疾病与肺癌发病风险的关联。以观察性研究中具有基因型数据的458 526名参与者为研究对象, 选择与4种慢性肺部疾病密切相关且相互独立的遗传位点作为工具变量, 采用孟德尔随机化(MR)分析4种慢性肺部疾病与肺癌发病风险的关联情况。采用限制性立方样条函数评估不同慢性肺部疾病GRS与肺癌发病风险的剂量反应关系。结果研究对象年龄的M(Q1, Q3)为57(50, 63)岁, 随访期间新发肺癌3 516例(0.74%)。多因素Cox比例风险回归模型分析结果显示:既往患有慢性阻塞性肺病和特发性肺纤维化与肺癌发病风险存在关联, 分别为1.61(1.49～1.75)和2.61(1.24～5.49)。MR研究结果显示:遗传预测的慢性阻...     

铝厂工人的癌症发生率和死因别死亡率

本研究介绍了铝工业对健康的危害 ,调研了暴露于多环芳烃 (PAH)和氟化物与19 5 4年和 195 7年挪威两家铝厂工人的癌症发生率和死因别死亡率之间的关联。方法 :本研究设计为历史队列研究 ,包括认定 5 6 2 7名受雇超过 6个月的男性。癌症发生率统计范围从受雇到 1995年 ,死因别死亡率从 196 2年～ 1995年。观察到的癌症病例和观察到的死亡数与按全国的比率计算的预期数目相对照 ,用泊松回归与考虑年龄和吸烟因素的模型 ,作组内对照。应用工业卫生测量和过程参数的统计模型 ,计算了既往 PAH和氟化物暴露量。用职业暴露模型调查累积暴露与癌…     

城市女性癌症患者 七成是“没脾气”的好女人

委曲求全未必好 4类职业女性是癌症易感人群 据调查组专家透露,研究小组通过对3万余病例调查后发现,性格、职业和心理因素与癌症有密切关联。研究显示,我国城市女性癌症患者中的七成人为“好女人”。她们往往在日常生活中特别认真、一丝不苟、不爱发火,生活有条不紊,但却是癌症的高发人群,癌症发生年龄也更为提前。     

膳食模式与癌症病因学的研究进展

近年来, 我国癌症发病率逐年上升, 推进癌症的一级预防是遏制该趋势的有效措施。膳食被视为多种癌症共同且可改变的影响因素, 而膳食模式考虑了食物和营养素间的相互作用, 在癌症预防方面更具实际指导意义。本文概述了膳食模式提取方法, 综述近年来膳食模式与消化系统、呼吸系统、生殖系统和泌尿系统癌症关联的研究结论并阐述可能的作用机制, 以期为后续研究提供参考依据。     

新发现8则

饮酒与癌症明显相关欧洲多国进行的大规模研究显示,饮酒与癌症之间存在明显的关联,研究人员呼吁人们为了身体健康应该减少饮酒。《英国医学杂志》刊登的这项研究报告说,英国、德国、法国等8个欧洲国家的研究人员联合调查了超过36万人的数据,结果显示,男性癌症病例中约10%都和饮     

中国3省城市癌症早诊早治项目地区肺癌高危人群的低剂量螺旋CT筛查依从性及相关因素分析

目的:分析中国3省城市癌症早诊早治项目地区肺癌高危人群的低剂量螺旋CT（LDCT）筛查依从性及相关因素。方法:于2017年10月至2018年10月,以浙江、安徽和辽宁3个省份作为研究现场,招募17 983名40~74岁肺癌高危人群为研究对象。采用癌症风险评估问卷收集基本人口学特征、生活习惯、疾病既往史和癌症家族史等信息...     

肺癌的全基因组关联研究进展

肺癌是人类最常见的癌症之一,是一种由环境因素和遗传因素共同作用的疾病。研究者应用全基因组关联研究策略发现了与肺癌发病相关的新位点,为肺癌的发病机制提供重要线索。本文对近年来肺癌全基因组关联研究发现的染色体遗传易感基因多态位点和有关人群肺癌特征的全基因组关联研究进行阐述,并对存在的局限性及未来的研究发展进行了讨论。     

中国人群癌症相关单核苷酸多态性的潜在多效性研究

目的:探讨中国人群癌症相关单核苷酸多态性（SNP）的潜在多效性。方法:基于美国国立人类基因组研究所及欧洲生物信息学研究所共同构建的全基因组关联研究（GWAS）目录,按照人群来源（中国人群与非中国人群）和疾病性状（癌症与非癌症性状）,将2020年8月以前所有GWAS发现SNP分为中国人群癌症、中国人群非癌症、非中国人群癌...     

血清铁、铜、锌浓度与癌症死亡危险

为了验证血清铁、铜、锌浓度与癌症死亡率前瞻性关联,采用经美国第2次全国健康与营养状况监测基线调查证实不患癌症的人群为研究样本,其中3000名男性,3244名女性。相对危险度通过对潜在混杂因素调整后的风险比例模型来确定。随访的83664.4人年中有307人死于癌症,癌症死亡率为3．7‰。血清铁、运铁蛋白、铜的调整死亡率有性别差异。结果表明血清铁、运铁蛋白、铜浓度高的人群癌症死亡危险性高。     

他汀类药物或可降低癌症死亡率

丹麦研究人员的新研究显示,服用降胆固醇的他汀类药物与癌症患者较低的死亡率具有关联。     

Efficacy of cervical cytologic screening in the control of cervical cancer

Cervical cancer mortality in the U.S. has been declining, and this has been attributed to cervical cytologic screening. This report reviews data on the incidence and mortality of cervical cancer in order to evaluate the effect of cytologic screening. U.S. cervical cancer mortality has been declining consistently since 1946, with little change in the mortality trend after widespread cytologic screening. Incidence of invasive cervical cancer in specific geographic areas has also declined. However, the rate of diagnosis of carcinoma in situ has increased sharply and parallels increasing cytologic screening rates. A causal association of cytologic screening with the decreasing mortality and incidence of invasive cervical cancer cannot be established using current data, especially considering declining mortality prior to widespread screening and increasing removal of women from the population at risk by hysterectomy.     

Changing places: the impact of rural restructuring on mental health in Australia

Significant demographic, social and economic change has come to characterise much of rural Australia, with some authors arguing there are now two sharply differentiated zones, one of growth and one of decline. This restructuring process, which has been similar to other western nations, has had a profound impact upon rural places-socially, economically and physically. Findings from research investigating the relationship between health, place and income inequality suggest that rural 'desertification', which is characterised by decline of the agricultural sector, net population loss and the deterioration of demographic structures, may negatively influence mental health outcomes in these areas. By contrast, the growth in rural areas, which is associated with expanding employment opportunities and the movement of capital and people, may confer positive benefits to mental health. The aim of this study was to investigate differences in mental health and well-being between rural communities experiencing growth and decline as measured by net population change. Utilising a survey methodology, questionnaires were distributed to 20,000 people randomly sampled from the electoral role in rural Australia. We selected four sub-regions from the sample area that were characteristic of areas experiencing population growth and decline in Australia and analysed the results of respondents from these four regions (n = 1334). The analysis provided support for our hypothesis that living in a declining area is associated with poorer mental health status; however, the factors that underpin growth and decline may also be important in influencing mental health. Discussed are the mechanisms by which demographic and social change influence mental health. The findings of this study highlight the diversity of health outcomes in rural areas and suggest that aspects of place in declining rural areas may present risk factors for mental health.     

Temporal trends of cancer mortality in eastern New England compared to the nation, 1950-1975

Cancer mortality trends among the white population in eastern New England are compared to National trends for the years 1950-1975 for 62 age and sex-standardized sites. The 26 years considered in the study are divided into five time periods (1950-1954, 1955-1959, 1960-1964, 1965-1969, 1970-1975) representing rates age-adjusted to the 1960 white population. The findings show that male cancer mortality in eastern New England is increasing at a rate consistently higher than and almost parallel to National male cancer mortality. Female cancer rates in eastern New England are declining, but less rapidly than National female cancer mortality. Female lung cancer in the study region has experienced a dramatic increase from 1950 to 1975; and the greatest increases occurred in areas of the lowest relative urbanization.     

Changing pattern of premature mortality burden over 6 years of rapid growth of the economy in suburban south-west China: 1998-2003

BACKGROUND: This study was conducted in Kunming, the capital of Yunnan, a poor province in south-west China experiencing rapid economic growth. The study examined the short-term trend in premature mortality burden from common causes of death in a suburban region between 1998 and 2003. METHODS: Years of life lost (YLL) per 1000 population and mortality rate per 100,000 population were calculated from medical death certificates, and broken down by cause of death, sex and year without age weighting but with a discounting rate of 3%. RESULTS: Non-communicable diseases contributed over 80% of all causes of YLL, with a slightly increasing trend. The combined rate for communicable, maternal, prenatal and nutritional deficiencies declined from 4.7 to 2.4 per 1000 population. Remarkably, declining trends in YLL were also seen for chronic obstructive pulmonary disease, drug use and road traffic accidents, whereas increasing trends were seen for ischaemic heart disease (IHD) and liver cancer (males). The YLL rate for stroke, self-inflicted injuries, lung cancer and stomach cancer fluctuated over time. CONCLUSIONS: The region should focus on further control of IHD and liver cancer.     

威海市文登区恶性肿瘤死亡趋势变化分析

目的对威海市文登区居民恶性肿瘤的死亡水平进行分析,了解恶性肿瘤的变化趋势。方法利用Joinpoint回归模型将威海市文登区2007~2012年恶性肿瘤死亡情况与20世纪70年代和90年代进行对比分析。结果威海市文登区恶性肿瘤粗死亡率由1970年的80.3/10万上升到2012年的195.01/10万,中调率由60.06/10万下降到57.31/10万;其中,食管癌呈下降趋势,肺癌呈上升趋势。Joinpoint模型结果显示,女性以2007年为折点呈先下降后升高的趋势,而男性的趋势则无统计学意义。结论威海市文登区居民恶性肿瘤标化死亡率虽呈下降趋势,但个别肿瘤呈上升趋势,加之人口老龄化日趋严重,仍需加强宣教,采取有效的干预措施。     

哈尔滨市南岗区恶性肿瘤流行病学调查

目的 :分析 1 992～ 2 0 0 1年哈尔滨市南岗区居民恶性肿瘤的发病率、死亡率及变化趋势 ,探讨主要恶性肿瘤发病、死亡原因。方法 :资料来源于南岗区卫生防疫站居民死因年报 ,采用ICD - 9进行死因分类 ,利用统计软件分析。结果 :十年间恶性肿瘤的发病、死亡率呈增高的趋势 ,是最主要的死亡原因之一。 1 992～ 2 0 0 1年的恶性肿瘤的报告发病率为 1 72 70 / 1 0万 ,呈增高的趋势 ,男性明显高于女性。十年间恶性肿瘤的死亡率为 1 2 4 30 / 1 0万 ,死亡率有下降的趋势 ,但其中肝癌和肺癌的死亡率上升明显。男性死亡明显高于女性。结论 :肺癌、肝癌、乳腺癌为恶性肿瘤发病的前三位 ,胰腺癌、胃癌略有下降趋势。     

LIFE EXPECTANCY FREE OF DISABILITY: A COMPOSITE MEASURE OF POPULATION HEALTH STATUS

Access to disability data from a nationwide survey of New Zealanders provides the opportunity to estimate Life Expectancy Free of Disability (LEFD) for the non-institutional adult population. This measure of population health status combines mortality and morbidity data into a single index. The analysis is restricted to the 15–64 age range and results on partial life expectancy free of disability are presented for the key socio-demographic groups. The results conform to the international evidence and highlight the potential impact of disability as a component in a composite measure of population health status: although women live longer than men, almost all this apparent advantage in longevity is spent in some state of disablement; Maori are disadvantaged in comparison with non-Maori both in terms of longevity and in the proportion of the life span spent disability-free; and, social class comparisons show a decline in LEFD with declining social class that is steeper than the corresponding mortality gradient. Despite some technical difficulties and the strong requirements of the data, the LEFD measure has many potential applications in public health research and planning. In particular, it has the potential to direct research and policy towards the enhancement of the active years of life rather than just the postponement of mortality.     

Patterns in cancer incidence among American Indians/Alaska Natives, United States, 1992-1999

OBJECTIVE: Cancer is a major public health concern in American Indian and Alaska Native (AI/AN) communities. However, information on the incidence of cancer is lacking for this group. The purpose of this study is to report cancer incidence patterns for the U.S. AI/AN population. METHODS: Age-adjusted annual cancer incidence rates for 1992 through 1999 were calculated for 12 Surveillance, Epidemiology and End Results (SEER) areas, representing a sample (42%) of the U.S. AI/AN population. Trends in cancer incidence rates for the AI/AN sample were determined using standard linear regression of log-transformed rates and were compared to those of the U.S. white population. RESULTS: The top five incident cancers (from highest to lowest) among AI/AN males were prostate, lung and bronchus, colon and rectum, kidney and renal pelvis, and stomach cancers. Among AI/AN women, cancers of the breast, colon and rectum, lung and bronchus, endometrium, and ovary ranked highest. Four sites where cancer incidence rates are greater for AI/ANs than for whites include gallbladder (the AI/AN rate was 4.1 times the rate for white males and 2.6 times the rate for white females), liver and intrahepatic bile duct cancers (1.3 times for males and 2.3 times for females), stomach (1.2 times for males and 1.5 times for females), and kidney and renal pelvis (1.03 times for males and 1.07 times for females). The data show increasing trends for AI/AN males and females and declining trends for white males and females for colorectal, stomach, and pancreatic cancers and leukemia. Similar differences between AI/AN rates and white rates were found for urinary bladder cancers in males and gallbladder cancer in females. CONCLUSIONS: Analysis of SEER data allowed for the determination of disparities in cancer incidence between a sample of the U.S. AI/AN population and the white population. The findings of this study provide baseline information necessary for developing cancer prevention and intervention strategies specific to the AI/AN population to address these cancer disparities.     

Elderly Men with Cancer:

Prostate cancer requires the attention of social workers in health care for three reasons: the growing elderly population which will increase the number diagnosed, the recent introduction of new treatments and the lack of social acceptability for this condition. Interventions for prostate cancer are specific to the stage of the disease. These individual, family and group interventions rae a model for social work services to elderly men with other forms of cancer. Social workers have opportunity to research quality of life and decision-making issues to enhance medical practise in prostate cancer.     

1990年与2013年中国人群肝癌疾病负担研究

目的 分析1990年与2013年中国人群肝癌疾病负担结果。方法 利用2013年全球疾病负担研究结果,描述中国人群肝癌的疾病负担现状,主要指标包括死亡率、伤残调整寿命年(DALY)。同时,用2013年全球疾病负担研究的标准人口,计算标化死亡率、标化DALY率,并计算2013年与1990年的变化幅度,描述疾病负担指标的变化。结果 2013年中国人群肝癌死亡总数约35.81万人,死亡率为25.85/10万,其中,继发于乙型肝炎(乙肝)的肝癌死亡约16.36万人(占45.69%),继发于丙型肝炎(丙肝)的肝癌死亡约13.42万人(占37.48%);肝癌造成的DALY为4080.40万人年,按照DALY排序,第一位依然是继发于乙肝的肝癌,其次是继发于丙肝的肝癌、其他肝癌、继发于酒精性肝病的肝癌,导致的DALY依次为465.20、339.43、96.43、59.21万人年,男性人群继发于肝病的肝癌DALY均显著高于女性。与1990年相比,肝癌标化死亡率下降25.00%,肝癌DALY绝对值上升16.95%,肝癌的年龄标化DALY率下降33.47%;其中,继发于丙肝的肝癌疾病负担日趋严重,23年来,其标化死亡率上升106.18%,标化DALY率上升91.68%。分年龄组来看,青壮年和老年人群的肝癌疾病负担最为严重,与1990年相比,肝癌标化DALY率在各个年龄段均呈现下降趋势,下降幅度最大是5~14岁,其中,继发于乙肝的肝癌DALY率在5~14岁年龄段下降幅度为46.37%,而继发于丙肝的肝癌DALY率在各个年龄段均呈上升趋势。结论 现阶段肝癌依然是造成严重疾病负担的恶性肿瘤之一,近年来,继发于乙肝的肝癌疾病负担下降,但继发于丙肝的肝癌疾病负担显著上升,男性人群肝癌疾病负担显著高于女性,开展针对性的防控措施迫在眉睫。