非吸烟女性肺癌危险因素病例对照研究

目的 探讨浙江省非吸烟女性患肺癌的危险因素。方法 采用1∶2配对的病例对照研究，收集浙江省30个县（区）2005年11月-2008年12月期间发病的新发非吸烟女性肺癌病例229例；配对对照选取患者，女性邻居、年龄＆#177;3岁、无吸烟史。通过面访调查收集有关危险因素的暴露史，采用单因素及多因素 Logistic 回归模型进行拟合，筛选肺癌的主要危险因素。结果 单因素分析发现有15个暴露因素与非吸烟女性肺癌的发生有关。多因素及因子分析发现，被动吸烟（OR ＝1.598，95％CI：1.016～2.512）、家族肿瘤史（OR ＝5.359，95％CI：1.658～17.326）、呼吸道病史（OR ＝24.427，95％CI：6.111～97.642）、精神心理因素不良（OR ＝2.622，95％CI：1.149～5.983）、人际关系不佳（OR ＝3.041，95％ CI：1.534～6.032）、做饭时自感油烟重（OR ＝1.856，95％CI：1.043～3.301）、常食用腌晒食品（OR ＝1.724，95％CI：1.205～2.466）和初潮年龄晚（OR ＝1.565，95％CI：1.086～2.253）等因素是肺癌发生的危险因素；收入水平高（OR ＝0.650，95％CI：0.484～0.873）和常食用新鲜蔬菜（OR ＝0.683，95％CI：0.504～0.926）是肺癌的保护因素。趋势性检验发现，非吸烟女性被动吸烟与肺癌的相对危险度之间存在一定剂量反应关系。结论 针对非吸烟女性肺癌的相关危险因素，需采取综合干预措施，以降低肺癌的发生率。

A case -control study on risk factors of lung cancer among non -smoking women

Objective To explore the risk factors of lung cancer among non -smoking women.Methods A total of 229 new cases of lung cancer among non -smoking women from 2005 to 2008 were collected.The design method of 1 to 2 matching case -control study was used controlling age,sex and smoking conditions.The data was analyzed by univariate and multivariate conditional logistic regression analysis.Results Single factor analysis identified 13 risk factors （all P 〈0.05）.The multivariate conditional logistic regression and factor analysis showed that respiratory disease history,family history of cancer,poor interpersonal relationship,psychological problems,feeling heavy smoke when cooking,consumption of salty and dry food,later menarche and passive smoking were risk factors （OR =24.427,5.539,3.041,2.622,1.856, 1.724,1.565 and 1.598 respectively）,high income level and high consumption of vegetables were protective factors （OR =0.650 and 0.683 ）.Conclusion respiratory disease history, family history of cancer, poor interpersonal relationship and psychological problems are main risk factors of lung cancer among non -smoking women.