中青年与老年非吸烟女性肺癌危险因素的比较研究

目的 分析比较中青年和老年非吸烟女性肺癌的危险因素。方法 于1992年2月～1993年12月，在上海市区完成了一项大规模全人群女性肺癌病例对照研究，共调查了非吸烟女性肺癌病例504例及人群对照601例。根据年龄把研究对象分为两组，35～54岁和55～69岁组，并分析比较两组的结果。单因素分析采用Mantel—Haenszel分层分析法，进一步调整混杂因素采用多变量logistic回归模型。结果分析结果显示，中青年组危险因素是做饭时眼和喉烟雾刺激感，最高一组比数比为3．40；其次是肺癌家族史，比数为5．80。而保护因素是饮茶(OR：0．40)和活产次数(5次及以上组OR：0．39)。老年组的危险因素主要是：高身体指数(最高一组OR：1．69)、工作场所被动吸烟史(OR：1.55)、厨房在卧室内(OR：1．50)、做饭时厨房内烟雾较多(OR：2．43)、菜油为主要食用油(OR：1.94)等。此外。肺结核病史和肺癌家族史可能增加老年女性患肺癌的危险性。保护因素是维生素C(最高一组OR：0．45)，趋势检验有统计学意义。中青年组和老年组肺癌的结果比较表明，无论是危险因素还是保护因素，两者都有不同。结论 中青年和老年非吸烟女性肺癌的病因可能存在一定的差异。

A population-based case-control study of lung cancer between young and older nonsmoking women in urban Shang-hai, P. R. China

Objective To explore and compare the risk factors of lung cancer between young and older nonsmoking women in urban Shanghai. Methods A population-based case-control study of lung cancer among nonsmoking women was conducted in urban Shanghai during Feb. 1992 to Dec. 1993. The data sets based on 504 newly cases and 601 population controls were used in the statistical analysis. The study subjects were divided into two groups by age (aged 35-54 and 55-64) for the comparison of risk factors. The univariate and multivariate analyses were performed by means of Mantel-Haenszel method and logistic regression model, respectively. Results The results indicated that cooking fumes and family history of lung cancer are the main risk factors for the young women. The odds ratio of highest quartile compared to the lowest one is 3.40 for the cooking fumes. The risk of young women with positive family history of lung cancer is 5.80 compared to the negative one. Tea drinking and numbers of live birth are the protective factors with the odds ratios of 0.40 and 0.39 (highest group compared to the baseline), respectively. The risk factors among older nonsmoking women are as following: higher body mass index (the highest OR: 1.69), exposure on passive smoking during working time (OR: 1.55), cooking in the bedroom (OR: 1.50), more cooking fumes in the kitchen (OR: 2.43) and more frequently intake of rapeseed oil (OR: 1.94). The lung TB and family histories of lung cancer maybe the potential risk factors for the female lung cancer among older adults. Vitamin C was associated with the decreasing risk of female lung cancer. The odds ratio (the highest quartile compared to reference) was 0.45, and the linear trend was also statistical significant after adjustment for confounding variables. The results suggested the clues on the different risk and protective factors of female lung cancer between young and older adults in urban Shanghai. Condusions The etiology of lung cancer among young nonsmoking women maybe different from that of older women