精神刺激史与结直肠癌发病关系的队列研究

目的:了解精神刺激因素和大肠癌发病的关系,分析精神刺激因素对于不同人群大肠癌发病的影响。方法:采用浙江省嘉善县的大肠癌普查建立队列人群,共计64460人,按照有无精神刺激史分成暴露组和非暴露组,其中暴露组为1784人,非暴露组为62676人,随访时间从1990年1月1日至2003年12月31日,观察其大肠癌发病情况;应用KaplanMeier、Cox回归和分层分析等生存分析统计方法,分别构造不同分析模型来比较两组人群大肠癌发病率的差异。结果:多因素Cox回归模型显示,年龄和吸烟史等因素与大肠癌发生有关,相对危险度(RR)分别为1.040(95%CI:1.021～1.060)和1.268(95%CI:1.008～1.594),同时,精神刺激史是男性结肠癌发生的危险因素(RR=2.823,95%CI:1.131～7.045);此外,其它因素未均见有统计学意义(P>0.05)。结论:精神刺激史与大肠癌发病有一定的关系,是男性结肠癌发生的危险因素。

History of psychological stress and colorectal cancer:a population-based prospective cohort study

Objective:To identify the association between incidence of colorectal cancer and the history of psychological stress and to determine the effects of psychological stress on the incidence of colorectal cancer in different populations. Methods:Based on a screening for colorectal cancer among residents in Jiashan County,a total of 64 460 residents consisted of the cohort population of this study. They were divided into two groups by their psychological stress history. There were 1 784 residents who reported the experience of psychological stress and 62 676 residents who reported no experience of psychological stress. Follow-up were performed to observe the incidence of colorectal cancer from 1st January 1990 to 1st December 2003. Kaplan-Meier,Cox regression model,and stratified analysis were applied to compare the relative risks (RR) between the two groups. Results: Multiple Cox regression analysis showed that age and smoking history had some relationship with colorectal cancer,and the relative rate was 1.040(95%CI:1.021-1.060) and 1.268 (95%CI:1.008-1.594),respectively. The history of psychological stress was a risk factor in the incidence of colorectal cancer in man(RR=2.823,95%CI:1.131-7.045),and other factor had no significant influence on the incidence of colorectal cancer(P>0.05). Conclusion:History of psychological stress has some relationship with the incidence of colorectal cancer,and it is the risk factor in the incidence of colorectal cancer in man.