武汉市前列腺癌的流行病学研究

本文在武汉市１９９０～１９９２年前列腺癌的发病及死亡报告的基础上进行了１∶１配比的病例对照研究，结果显示武汉市前列腺癌的发病率和死亡率分别为１．３７／１０万和０．７５／１０万，世界人口年平均标化发病率和死亡率分别为１．１０／１０万和０．６６／１０万。泌尿系统病史（ＯＲ＝５．４２，９５％可信区间＝１．５６～１８．８３）、子女数超过３个（ＯＲ＝２．４３，９５％可信区间＝１．１７～５．０２）、每周性交超过３次（ＯＲ＝３．３８，９５％可信区间＝１．５１～７．５８）、滥用药物（ＯＲ＝４．１１，９５％可信区间＝１．６５～１０．２５）、体质指数高（ＯＲ＝２．５８，９５％可信区间＝１．３０～５．１１）等是前列腺癌的危险因素，而体力劳动（ＯＲ＝０．３５，９５％可信区间＝０．１７～０．７１）、初次遗精年龄晚于１８岁（ＯＲ＝０．２０，９５％可信区间＝０．０８～０．５２）等是其保护性因素。     

云南省瑞丽市静注毒品人群HIV感染者死亡情况调查

采用回顾性前瞻研究对１９８９年１０月～１９９３年１０月瑞丽市静注毒品人群ＨＩＶ感染者死亡情况进行调查。在观察期内，３９５名ＨＩＶ阳性队列中死亡６１人，累计死亡率１５．４％；对照组１９２名ＨＩＶ阴性静注毒品队列死亡１８人，累计死亡率９．４％，两相比较差异显著（Ｐ＜０．０５），相对危险度（ＲＲ）１．６（９５％可信区间１．０～２．５）。按死因分类后，两队列死因不明和意外死亡类别差异不显著（Ｐ＞０．０５），且均保持较高的主要为由吸毒过量、殴斗自杀行为所致的意外性死亡率（分别为４．７％、５．８％）。但是，在因病死亡类别，ＨＩＶ阳性队列死亡率为８．４％，显著高于ＨＩＶ阴性队列３．１％的水平（Ｐ＜０．０５），ＲＲ为２．７（９５％可信区间２．１～６．１）。若去除ＨＩＶ阳性队列中２名ＡＩＤＳ死亡病例后，比较两队列非ＡＩＤＳ性死亡率，ＨＩＶ阳性队列为１３．９％，ＨＩＶ阴性队列为７．９％，差异显著（Ｐ＜０．０５），ＲＲ为１．７（９５％可信区间１．０～２．８）。结果表明，瑞丽市的静注毒品者中，ＨＩＶ阳性人群死于疾病的机会较ＨＩＶ阴性人群高，其中可能包括部分漏报的ＡＩＤＳ病例，提示今后应加强对基层卫生人员有关ＡＩＤＳ诊断标准的培训。     

阿斯匹林预防老年缺血性脑血管病多中心前瞻性对照研究

５８４例老年轻型缺血性卒中（ＭＩＳ）或ＴＩＡ病人随机分为阿斯匹林（ＡＳＡ）组３０１例与对照组２８３例，随访１２～６０（平均３０．２）月的结果发现：ＡＳＡ组卒中发生率与死亡发生率（１０．６％与４．３％）均低于对照组（１４．９％与７．１％），但均未达统计学差异性（Ｐ＞０．０５），ＡＳＡ组卒中与死亡危险性较对照组降低３２％〔相对危险性（ＲＲ）为０．６８，９５％可信区间为０．４６～１．０１〕；ＡＳＡ组卒中、血管性死亡及心肌梗塞发生率（２０．６％）显著低于对照组（３１．１％）（Ｐ＜０．００５），ＡＳＡ组卒中、血管性死亡及心肌梗塞危险性较对照组降低３３．８％（ＲＲ为０．６６，９５％可信区间为０．４８～０．９２）；ＡＳＡ组副作用发生率为１８．９％，严重副作用为２．７％。     

谷胱甘肽转硫酶M1,T1基因型与胃癌易感性的关系

目的　探讨谷胱甘肽转硫酶Ｍ１（ＧＳＴＭ１）、Ｔ１（ＧＳＴＴ１）基因型与胃癌危险性的关系。方法　采用病例对照分子流行病学研究方法和聚合酶链反应技术, 检测９５ 例原发性胃癌病例和９４ 例对照者ＧＳＴＭ１ 和ＧＳＴＴ１ 基因型。结果　ＧＳＴＭ１ 基因缺失［ＧＳＴＭ１（－ ）］ 频率在病例组和对照组分别是６３－１６％ 和４５．７４％ ,差异有显著性（χ２ ＝５ ．７５,Ｐ＝ ０．０１６ ５） ,ＧＳＴＭ１ 基因缺失与胃癌易感性有关（ＯＲ＝ ２．０３,９５％ 可信区间＝１．０９～３．８０ ）。携带ＧＳＴＭ１（ －） 和ＧＳＴＴ１（＋ ）基因型者发生胃癌的危险性显著高于ＧＳＴＭ１（ ＋） 和ＧＳＴＴ１（ －） 基因型携带者,比值比ＯＲ＝２．９１,９５％ 可信区间＝１．０９～７．８９。ＧＳＴＭ１ 基因缺失同时暴露于吸烟者患胃癌的危险性显著增高（ ＯＲ＝ ８．０６ ,９５％ 可信区间＝ ２．８３ ～２３．６７） 。结论　ＧＳＴＭ１ 基因缺失型可增加胃癌发生的危险性。     

煤工尘肺死亡的回顾性队列研究

为探索煤工尘肺病人的主要死因以及煤工尘肺与恶性肿瘤死亡之间的关系，采用流行病学回顾性队列研究方法对开滦矿务局１９５２～１９９５年诊断的３２２８例煤工尘肺患者（全部为男性）的结局进行了调查。队列观察从１９７０年１月１日开始，至死亡病例的死亡日期或１９９５年１２月３１日终止，以全国男性人群为参照。用标化死亡比（ＳＭＲ）作为统计指标，并计算９５％可信区间（９５％ＣＩ）。结果：全死因ＳＭＲ较全国人群高１１％（ＳＭＲ＝１．１１，９５％ＣＩ：１．０４～１．１８）。其中肺心病死亡（ＳＭＲ＝５．９７，９５％ＣＩ：５．２３～６．７７）、肺结核死亡（ＳＭＲ＝３．６８，９５％ＣＩ：３．０１～４．４６）均高于全国人群。全癌死亡低于全国人群（ＳＭＲ＝０．８１，９５％ＣＩ：０．７１～０．９２），但肺癌死亡高于全国人群（ＳＭＲ＝１．３６，９５％ＣＩ：１．１０～１．６６）。按不同死亡年代及粉尘种类进一步分析，均发现肺癌高发。结果表明：煤工尘肺病人的全死因死亡比稍高于全国人群，其中，肺心病和肺结核有明显的超额死亡。煤工尘肺病人中肺癌死亡超高。提示：煤工尘肺与肺癌的发生有关。     

膳食营养素摄入与前列腺癌

为探讨膳食营养素与前列腺癌的关系，对１０２例前列腺癌患者进行了１∶１配比的病例对照研究。根据近三月食物摄入量的平均值计算蛋白质、脂肪、糖类等１１种营养素及总执量的日平均摄入量，采用配对ｔ检验和条件Ｌｏｇｉｓｔｉｃ回归分析。结果表明：脂肪、糖类、视黄醇当量等的摄入量大能增加前列腺癌的危险性，维生素Ｃ、维生素Ｂ１等能降低其危险性，各营养素的多变量调整ＯＲ值及９５％可信区间分别为脂肪１．６５（１．３９～１．９６）、碳水化合物１．２２（１．１３～１．３１）、视黄醇当量３．１２（２．１８～４．７５）、维生素Ｃ０．６１（０．４６～０．８０）、维生素Ｂ１０．０２９（０．００９～０．０９）。本文还对各营养素增加或降低前列腺癌危险性的可能机制进行了讨论。     

结肠癌的饮食危险因素

结肠癌是常见恶性肿瘤之一，在胃肠道癌中居第二位。预防结肠癌的发病，饮食因素是不可忽视的。目前认为，结肠癌的饮食危险因素如下：１、高脂饮食。成人脂肪供给量所占每日总热量以不超过３５％为宜，其中须含足量必需脂肪酸（多存在于植物油中）。如果长期摄入高脂饮食...     

上海南汇县原发性肝癌危险因素的定群研究

通过对南汇县近８万人群的定群研究，运用Ｌｏｇｉｓｔｉｃ多无回归分析方法，发现肝炎发病时间（年）ＯＲ为１．０３（９５％可信限１．０２～１．０４）、饮用沟塘水ＯＲ为１．１６（９５％可信限１．０２～１．３２）、小河水ＯＲ为１．２５（９５％可信限１．０９～１．４３）这些是南汇县原发性肝癌发生的危险因素，而饮用浅井水ＯＲ为０．６５（９５％可信限０．５９～０；７３）、深井水（自来水）ＯＲ为０．２０（９５％可信限０．１６～０．２５）是肝癌发生的保护因素，为该县肝癌预防和高危人群的确定提供了理论依据。     

吸烟和多发性硬化症

实验数据表明，多发性硬化症（MS）的发生可能与吸烟有关，但这方面的流行病学研究还很少，不具有说服力。以美国女性为研究对象的两组队列研究评价了MS发病率与吸烟的关系。在调整了年龄、地域和血统因素后，与不吸烟的女性相比，现时吸烟女性MS的相对发病率为1．6（95％可信区间：1．2，2．1），既往吸烟女性为1．2（95％可信区间：0．9，1．6）。随着累积吸烟量的增多，MS的相对发病率明显增加（P＜0．05），调整了其他潜在混杂因素后也得到了相似的结果。虽然这些预期结果还不能证实二者之间存在因果关系，但研究者认为吸烟使人们患MS的危险性增加。     

低危人群中乳腺癌与人工流产相关关系的研究

探讨人工流产与乳腺癌发病危险性之间的关系。方法研究对象为经产妇。资料以条件Ｌｏｇｉｓ－ｔｉｃ回归模型分析。教育程度，以及初产年龄，采用过人工流产的妇女患乳腺癌的危险性比对照高２．９（ＲＲ＝２．９）倍，９５％ＣＩ为１．４－４．４（９５％ＣＩ＝１．４－４．４）。而在低于３５岁的妇女中，其相对危险度为４．５，９５％ＣＩ为１．９－１０．７（ＲＲ＝４．５，９５％ＣＩ＝１．９－１０．７），高于３５岁的妇女中，     

Citrus fruits intake and prostate cancer risk: a quantitative systematic review

OBJECTIVES: The purpose of this systematic review was to investigate the association between dietary intake of citrus fruits and prostate cancer risk. METHODS: Authors searched electronic databases and the reference lists of publications of diet and prostate cancer studies until August 2007. All of the epidemiological studies that obtained individual data on dietary intake of citrus fruits and presented risk estimates of the association between intake of citrus fruits and risk of prostate cancer were identified and included. Using general variance-based methods, study-specific odds ratios (OR)/ relative risk (RR) and associated confidence interval (CI)/ standard error (SE) for highest versus lowest intake of citrus fruits level were extracted from each paper. RESULTS: Eleven articles including six case-control studies, one nested case-control study and four cohort studies, proved eligible. Overall summary OR using random effect model did not show an association in risk of prostate cancer with intake of citrus fruits (summary OR=1.03, 95% CI=0.89-1.19) with large heterogeneity across studies that we were unable to explain (I(2)=67.88%). The summary ORs in case-control studies and cohort studies were 1.10 (95% CI=0.97-1.22) and 1.05 (95% CI=0.96-1.14), respectively. CONCLUSIONS: Pooled results from observational studies did not show an association between intake of citrus fruits and the risk of prostate cancer, although results vary substantially across studies.     

Dietary fat, cooking fat, and breast cancer risk in a multiethnic population

Our objective was to examine the association between dietary fat intake, cooking fat usage, and breast cancer risk in a population-based, multiethnic, case-control study conducted in the San Francisco Bay area. Intake of total fat and types of fat were assessed with a food frequency questionnaire among 1,703 breast cancer cases diagnosed between 1995 and 1999 and 2,045 controls. In addition, preferred use of fat for cooking was assessed. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). High fat intake was associated with increased risk of breast cancer (highest vs. lowest quartile, adjusted OR = 1.35, 95% CI = 1.10-1.65, P(trend) < 0.01). A positive association was found for oleic acid (OR = 1.55, 95% CI = 1.14-2.10, P(trend) < 0.01) but not for linoleic acid or saturated fat. Risk was increased for women cooking with hydrogenated fats (OR = 1.58, 95% CI = 1.20-2.10) or vegetable/corn oil (rich in linoleic acid; OR = 1.30, 95% CI = 1.06-1.58) compared to women using olive/canola oil (rich in oleic acid). Our results suggest that a low-fat diet may play a role in breast cancer prevention. We speculate that monounsaturated trans fats may have driven the discrepant associations between types of fat and breast cancer.     

Dietary Fat Intake and the Risk of Skin Cancer: A Systematic Review and Meta-Analysis of Observational Studies

Abstract

We conducted a meta-analysis to evaluate the association between fat intake and the risk of three major types of skin cancer including basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and cutaneous malignant melanoma (CMM). A comprehensive search of PubMed and EMBASE was performed to identify all relevant observational studies published up to December 1, 2018. Specific odds ratio (OR) or relative risk (RR) estimates for the highest versus the lowest intake of dietary fat and 95% confidence intervals (CI) from the included studies were pooled using random effect model. Three prospective cohort studies (175,675 participants and 30,915 BCC cases, 4,106 SCC cases and 1,638 CMM cases) and nine case-control studies (328 BCC cases, 493 SCC cases, 1,547 CMM cases and 2,660 controls) were identified. The pooled results indicated that dietary consumption of total fat and saturated fat were not associated with three major types of skin cancer. High consumption of monounsaturated fat was significantly associated with a decreased risk of BCC (RR: 0.90, 95% CI: 0.85–0.96) and high level of polyunsaturated fat intake was potentially positively associated with SCC (RR: 1.19, 95% CI: 1.06–1.33). Our findings should be confirmed by further evidence from well-designed and large-scale prospective cohort studies.     

Dietary patterns related to glycemic index and load and risk of premenopausal and postmenopausal breast cancer in the Western New York Exposure and Breast Cancer Study

BACKGROUND: Reduced rank regression (RRR) has been used to identify dietary patterns that predict variation in a selected risk factor and may be useful in describing dietary exposures associated with glycemic index (GI) and glycemic load (GL). OBJECTIVE: To estimate breast cancer risk, we compared the relative utility of RRR-derived dietary patterns predictive of GI and GL with those of simple GI and GL. DESIGN: RRR was used to identify dietary patterns predicting GI and GL from food-frequency data obtained in the Western New York Exposure and Breast Cancer Study (1166 cases, 2105 controls). Odds ratios (ORs) and 95% CIs were estimated with unconditional logistic regression, adjusted for energy and nondietary breast cancer risk factors. RESULTS: Sweets, refined grains, and salty snacks explained 34% of the variance in GI and 68% of the variance in GL. In general, breast cancer risks were not associated with GI, GL, or dietary pattern score. However, we observed a significant reduction in postmenopausal breast cancer risk with GI and GL pattern scores combined (OR: 0.68; 95% CI: 0.50, 0.93), especially in women with a body mass index (in kg/m(2)) >or=25 (OR: 0.64; 95% CI: 0.44, 0.93). Conversely, in premenopausal women, increased risks were associated with high GL pattern scores only for women with a body mass index >or=25 (OR: 2.21; 95% CI: 1.04, 4.69). CONCLUSIONS: Although RRR may be useful in studies of diet and disease, our results suggest that RRR dietary patterns based on GI and GL provide similar information regarding the association between breast cancer, GI, and GL.     

Meta-Analysis of Black Tea Consumption and Breast Cancer Risk: Update 2013

Black tea is a commonly consumed beverage in the world, comprising approximately 80% of all tea consumed. We sought to examine the association between black tea consumption and risk of breast cancer, using all available epidemiologic evidence to date. PubMed, EMBASE, ISI Web of Science, Chinese National Knowledge Infrastructure Database, and China Biological Medicine Database were used to search for citations using the MeSH terms as “breast neoplasm” AND “black tea.” Then we performed a meta-analysis of studies of breast cancer risk published between 1985 and 2013 by using RevMan 5.0 software. The results showed that no association between black tea consumption and breast cancer risk in overall [odds ratio (OR) = 0.97; 95% confidence interval (CI) = 0.89–1.05]. We further performed a stratified analysis according to region (United States/Europe). Black tea consumption did not decrease breast cancer risk in the United States (OR = 0.91; 95% CI = 0.78–1.07) and in Europe (OR = 0.99; 95% CI = 0.93–1.06). In addition, the summary OR from all cohort studies (OR = 1.04, 95% CI = 0.91–1.18) or all case-control studies (OR = 0.95, 95% CI = 0.88–1.02) showed black tea intake has no effects on breast cancer risk. However, the association between black tea consumption and breast cancer incidence remains unclear based on the current evidence. Further well-designed large studies are needed to confirm our result.     

Ultraviolet sunlight exposure during adolescence and adulthood and breast cancer risk: a population-based case-control study among Ontario women

Recent studies suggest that vitamin D may be associated with reduced breast cancer risk, but most studies have evaluated only dietary vitamin D intake. The associations among ultraviolet radiation from sunlight, factors related to cutaneous vitamin D production, and breast cancer risk were evaluated in a population-based case-control study conducted in Ontario, Canada, between 2003 and 2004 (n = 3,101 cases and n = 3,471 controls). Time spent outdoors was associated with reduced breast cancer risk during 4 periods of life (>21 vs. ≤6 hours/week age-adjusted odds ratio (OR) = 0.71, 95% confidence interval (CI): 0.60, 0.85 in the teenage years; OR = 0.64, 95% CI: 0.53, 0.76 in the 20s-30s; OR = 0.74, 95% CI: 0.61, 0.88 in the 40s-50s; and OR = 0.50, 95% CI: 0.37, 0.66 in the 60s-74 years). Sun protection practices and ultraviolet radiation were not associated with breast cancer risk. A combined solar vitamin D score, including all the variables related to vitamin D production, was significantly associated with reduced breast cancer risk. These associations were not confounded or modified by menopausal status, dietary vitamin D intake, or physical activity. This study suggests that factors suggestive of increased cutaneous production of vitamin D are associated with reduced breast cancer risk.     

Dietary Fat,Cooking Fat,and Breast Cancer Risk in a Multiethnic Population

Our objective was to examine the association between dietary fat intake, cooking fat usage, and breast cancer risk in a population-based, multiethnic, case-control study conducted in the San Francisco Bay area. Intake of total fat and types of fat were assessed with a food frequency questionnaire among 1,703 breast cancer cases diagnosed between 1995 and 1999 and 2,045 controls. In addition, preferred use of fat for cooking was assessed. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). High fat intake was associated with increased risk of breast cancer (highest vs. lowest quartile, adjusted OR = 1.35, 95% CI = 1.10–1.65, P _trend < 0.01). A positive association was found for oleic acid (OR = 1.55, 95% CI = 1.14–2.10, P _trend < 0.01) but not for linoleic acid or saturated fat. Risk was increased for women cooking with hydrogenated fats (OR = 1.58, 95% CI = 1.20–2.10) or vegetable/corn oil (rich in linoleic acid; OR = 1.30, 95% CI = 1.06–1.58) compared to women using olive/canola oil (rich in oleic acid). Our results suggest that a low-fat diet may play a role in breast cancer prevention. We speculate that monounsaturated trans fats may have driven the discrepant associations between types of fat and breast cancer.     

Association between Dietary Isoflavones in Soy and Legumes and Endometrial Cancer: A Systematic Review and Meta-Analysis

Background

Epidemiologic studies have reported conflicting findings between soy- and legume-derived dietary isoflavones and risk of endometrial cancer.

Dietary patterns and risk of incident gastric adenocarcinoma

Few studies have assessed the relation between dietary patterns and gastric adenocarcinoma risk, yet this approach has advantages over single-nutrient analysis, including the ability to reflect eating patterns in populations and ease of implementing dietary recommendations. The authors evaluated associations between dietary patterns, a food index score, and incident gastric cancer risk in a Canadian study of 1,169 cases and 2,332 controls (1995-1997). Dietary patterns were assessed via factor analysis applied to a food frequency questionnaire. A food index score was derived based on risk factors for gastric cancer. A multivariable-adjusted prudent dietary pattern was associated with decreased risk of gastric cancer in women (odds ratio (OR) = 0.58, 95% confidence interval (CI): 0.37, 0.92); a Western dietary pattern was associated with increased risk in women (OR = 1.86, 95% CI: 1.20, 2.89) and men (OR = 1.44, 95% CI: 1.03, 2.02). The food index score was associated with decreased risk among women (OR = 0.40, 95% CI: 0.27, 0.59) and men (OR = 0.63, 95% CI: 0.45, 0.88). Dietary patterns especially characterized by Western features (soft drinks, processed meats, refined grains, and sugars) were associated with increased risk of gastric adenocarcinoma, whereas dietary patterns characterized by increased consumption of fruits, vegetables, and fish were associated with lessened risk.     

Dietary fat, fiber, vegetable, and micronutrients are associated with overall survival in postmenopausal women diagnosed with breast cancer

Relatively few studies have assessed the relationship between dietary intakes and survival after breast cancer diagnosis. We investigated the influence of diet, including dietary fat (percentage energy), fiber, vegetable, and fruit intakes, and micronutrients (folate, carotenoids, and vitamin C) on overall survival in women diagnosed with breast cancer. Subjects were postmenopausal women diagnosed with breast cancer (N = 516) between 1994 and 1995 with a mean survival time of 80 mo (SD: 18). Subjects completed a food frequency questionnaire for the year prior to diagnosis. Cox proportional hazards models were used to measure the relationship between dietary intakes and death due to any cause after breast cancer diagnosis. In the multivariate analysis, we found that the hazard ratio [HR and 95% confidence interval (CI)] of dying in the highest tertile compared to the lowest tertile of total fat, fiber, vegetable, and fruit was 3.12 (95% CI = 1.79-5.44), 0.48 (95% CI = 0.27-0.86), 0.57 (95% CI = 0.35-0.94), and 0.63 (95% CI = 0.38-1.05), respectively (P 相似文献