Current status and clustering analysis of risk factors in high-risk groups of esophageal cancer in Yangzhong City, Jiangsu Province
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摘要:
目的 分析江苏省扬中市食管癌高危人群危险因素流行、聚集现状并探讨危险因素聚集的影响因素。 方法 以上消化道癌早诊早治及食管癌专病队列项目为依托，运用多阶段分层整群抽样的方法，抽取扬中市2 591名40~69岁高危人群进行一对一式面访调查，采用单因素Logistic回归分析模型及多因素Logistic回归分析模型探讨危险因素聚集的影响因素。 结果 扬中市食管癌高危人群吸烟、饮酒、烫热饮食摄入、进食过快、室内空气污染、牙齿缺失和危险因素聚集的流行率分别为22.27%、17.79%、16.79%、26.94%、18.45%、32.15%和40.22%。最常见的危险因素聚集模式为室内空气污染+牙齿缺失、吸烟+饮酒和进食过快+牙齿缺失。多因素Logistic回归分析模型分析显示，在男性、年龄大、文化程度低和农村高危人群中危险因素聚集性较高(均有P < 0.05)。 结论 扬中市食管癌高危人群中部分危险因素暴露还处于较高水平且危险因素存在明显的聚集，男性、年龄大、文化程度低和农村地区居民是食管癌防控的重点人群。 Abstract:Objective To analyze the prevalence and clustering of esophageal cancer risk factors and explore the influencing factors of its clustering among high-risk groups of esophageal cancer in Yangzhong, Jiangsu Province. Methods Relying on the early diagnosis and treatment of upper gastrointestinal cancer and esophageal cancer-specific disease cohort project, we used multi-stage stratified cluster sampling and 2 591 high-risk populations aged 40 to 69 years old were selected for a one-to-one interview survey. Univariate Logistic regression analysis and multivariate Logistic regression analysis were used to explore the influencing factors of risk clustering. Results The prevalence rates of smoking, drinking, hot diet intake, eating too fast, indoor air pollution, teeth loss among participants were 22.27%, 17.79%, 16.79%, 26.94%, 18.45%, 32.15% and 40.22%, respectively. The most common clustering patterns of risk factors were indoor air pollution + teeth loss, smoking + drinking and eating too fast + teeth loss. Multivariate Logistic regression analysis showed that the risk factors clustering was higher among men, older, low-educated, and rural high-risk groups (all P < 0.05). Conclusions The exposure of some risk factors among high-risk populations of esophageal cancer in Yangzhong City is still at a relatively high level, and there is an apparent clustering of risk factors. Males, the elder, residents with low education level and in rural areas are the key groups for the prevention and control of esophageal cancer. -
Key words:
- Esophageal cancer /
- High-risk groups /
- Risk factors /
- Prevalence rate /
- Clustering
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表 1 扬中市食管癌高危人群一般特征[n(%)]
Table 1. General characteristics of high-risk groups of esophageal cancer in Yangzhong [n(%)]
特征 男性 女性 合计 年龄组(岁) 40~ 272(23.88) 349(24.04) 621(23.97) 50~ 479(42.05) 622(42.84) 1 101(42.49) 60~69 388(34.06) 481(33.13) 869(33.54) 婚姻状况 已婚 1 105(97.01) 1 330(91.60) 2 435(93.98) 其他 34(2.99) 122(8.40) 156(6.02) 文化程度 小学及以下 288(25.29) 678(46.69) 966(37.28) 初中 578(50.75) 655(45.11) 1 233(47.59) 高中 247(21.69) 108(7.44) 355(13.70) 大专及以上 26(2.28) 11(0.76) 37(1.43) 职业a 体力劳动 808(70.94) 833(57.37) 1 641(63.33) 白领 88(7.73) 30(2.07) 118(4.55) 其他 243(21.33) 589(40.56) 832(32.11) 家庭年收入(万元) < 3 66(5.79) 116(7.99) 182(7.02) 3~ 109(9.57) 158(10.88) 267(10.30) 5~ 178(15.63) 215(14.81) 393(15.17) 7~ 171(15.01) 207(14.26) 378(14.59) 9~ 161(14.14) 212(14.60) 373(14.40) > 11 454(39.86) 544(37.47) 998(38.52) 居住地 城镇 211(18.53) 330(22.73) 541(20.88) 农村 928(81.47) 1 122(77.27) 2 050(79.12) 合计 1 139(43.96) 1 452(56.04) 2 591(100.00) 注：a职业：体力劳动包括农、林、牧、渔劳动者，服务人员和生产工人；白领包括行政管理人员和专业技术人员；其他包括学生，失业，全职家务和退休人员[13]。 
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表 2 扬中市食管癌高危人群6种危险因素聚集现状[n(%)]
Table 2. The clustering of 6 risk factors among high-risk groups of esophageal cancer in Yangzhong [n(%)]
危险因素数量 男性 女性 合计 0 138(12.12) 538(37.05) 676(26.09) 1 302(26.51) 571(39.33) 873(33.69) 2 357(31.34) 298(20.52) 655(25.28) 3 229(20.11) 44(3.03) 273(10.54) 4 90(7.90) 1(0.07) 91(3.51) 5 22(1.93) 0(0.00) 22(0.85) 6 1(0.09) 0(0.00) 1(0.04) ≥2(聚集) 699(61.37) 343(23.62) 1 042(40.22)
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表 3 扬中市食管癌高危人群6种危险因素聚集模式
Table 3. The clustering pattern of 6 risk factors among high-risk groups of esophageal cancer in Yangzhong
危险因素数量 吸烟 饮酒 烫热饮食 进食过快 室内空气污染 牙齿缺失 构成比(%) 2 - - - - + + 14.78 2 + + - - - - 6.05 2 - - - + - + 5.76 3 + + - + - - 3.55 3 + + + - - - 3.26 3 + - + + - - 2.98 4 + + + + - - 2.88 4 + + + - - + 1.34 4 + - + + - + 1.06 5 + + + + - + 1.06 5 + + + - + + 0.58 5 + + - + + + 0.19 5a + + + + + - 0.19 6 + + + + + + 0.10 注：列出了各危险因素数量中排名前3位的聚集模式。a5：与顺位第3并列。
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表 4 扬中市食管癌高危人群危险因素聚集影响因素Logistic回归分析模型
Table 4. Logistic regression analysis of influencing factors for clustering of risk factors in high-risk groups of esophageal cancer in Yangzhong
因素 聚集(%) 单因素分析 多因素分析 β值 OR(95% CI)值 P值 β值 OR(95% CI)值 P值 性别 男 61.37 1.000 1.000 女 23.62 -1.636 0.195(0.164~0.231) < 0.001 -1.851 0.157(0.129~0.191) < 0.001 年龄(岁) 40~ 26.89 1.000 1.000 50~ 36.69 0.455 1.576(1.270~1.955) < 0.001 0.472 1.604(1.263~2.037) < 0.001 60~69 54.20 1.169 3.217(2.577~4.017) < 0.001 1.032 2.807(2.120~3.717) < 0.001 婚姻状况 其他 44.23 1.000 已婚 39.96 -0.175 0.839(0.606~1.163) 0.292 文化程度 小学及以下 44.72 1.000 1.000 初中 36.17 -0.356 0.701(0.590~0.832) < 0.001 -0.321 0.725(0.574~0.916) 0.007 高中 41.69 -0.124 0.884(0.691~1.130) 0.325 -0.443 0.642(0.468~0.881) 0.006 大专及以上 43.24 -0.060 0.942(0.485~1.827) 0.859 -0.225 0.798(0.377~1.693) 0.557 职业 体力劳动 40.1 1.000 白领 49.15 0.368 1.444(0.993~2.099) 0.054 其他 39.18 -0.038 0.962(0.811~1.142) 0.661 家庭年收入(万元) < 3 52.2 1.000 3~ 52.81 0.025 1.025(0.703~1.494) 0.899 5~ 39.44 -0.517 0.596(0.418~0.850) 0.004 7~ 40.21 -0.485 0.616(0.431~0.879) 0.008 9~ 37.53 -0.597 0.550(0.384~0.788) 0.001 > 11 35.97 -0.665 0.515(0.374~0.707) < 0.001 居住地 农村 43.12 1.000 1.000 城镇 29.21 -0.609 0.544(0.443~0.668) < 0.001 -0.367 0.693(0.548~0.875) 0.002
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