| 王俊,高玉堂,王学励,刘恩菊,张玉兰,袁剑敏.上海市区男性吸烟与恶性肿瘤死亡的前瞻性研究[J].中华流行病学杂志,2004,25(10):837-840 |
| 上海市区男性吸烟与恶性肿瘤死亡的前瞻性研究 |
| Cigarette smoking and cancer mortality:a prospective cohort study in urban males in Shanghai |
| 收稿日期:2003-12-29 出版日期:2014-09-18 |
| DOI： |
| 中文关键词: 吸烟|恶性肿瘤|死亡率|前瞻性研究 |
| 英文关键词: Smoking|Cancer|Mortality|Prospective study |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨上海市区中老年男性吸烟与恶性肿瘤死亡关系,以及随访期间研究对象吸烟情况的改变对这种关系的影响。方法 自1986年1月至1989年9月调查上海市区45～64岁男性居民18244人,每年上门随访一次;用Cox比例风险模型计算相对危险度(RR)。结果 至2002年度随访结束,全队列共随访235762人年,人均随访12.9年。在此期间共死亡3365例,其中恶性肿瘤死亡1381例。基线调查时吸烟者相对于不吸烟者总死亡RR值为1.49,去除随访期间吸烟情况有变化的对象后,一直吸烟者相对于一直不吸烟者的总死亡RR值增至1.78;相应的恶性肿瘤死亡RR值由2.05增至2.58,肺癌死亡RR值由6.40增至8.77。基线调查时吸烟者年龄标化总死亡率及标化恶性肿瘤死亡率为1695.6/10万人年和782.0/10万人年,去除随访期间吸烟情况有变化的对象后,一直吸烟者相应的标化死亡率增至2353.7/10万人年和1144.6/10万人年。结论 吸烟是上海市区中老年男性总死亡及恶性肿瘤死亡的重要危险因素。不考虑随访期间研究对象吸烟状况的改变会低估吸烟对健康的危害性。 |
| 英文摘要: |
| Objective To investigate the association between cigarette smoking and cancer mortality in urban men in Shanghai and its impact when smoking habit changed during the follow-up period. Methods A total of 18 244 male residents aged 45 to 64 years in urban Shanghai were enrolled in the study during January 1, 1986 through September 30, 1989, and was actively followed up on annual visits. Cox proportional hazards model was used to estimate relative risks (RR). Results By the end of follow-up program in 2002, 235 762 person-years,averaged 12.9 years per subject in the cohort was reached. 3365 deaths including 1381 cancer deaths were registered during the follow-up period. The mortality rates for cancers of lung, stomach, liver, pancreas, esophagus, head and neck etc. increased significantly among smokers. Compared with data of nonsmokers at the baseline survey, the adjusted RR was 1.49 for allcauses mortality among current smokers at the baseline survey. After excluding subjects who changed their smoking habit during the follow-up period, the RR became 1.78 compared with lifelong-nonsmokers. The corresponding RRs rose from 2.05 to 2.58 for all cancer deaths and from 6.40 to 8.77 for lung cancer deaths. The age-adjusted all-causes and cancer death rates among current smokers at the baseline survey were 1695.6 and 782.0 per 100 000 person-years,respectively. After exclusion of those with smoking habit changed during the follow-up period, the rates among persistent smokers were 2353.7 and 1144.6 per 100 000 person-years,respectively. Conclusion Cigarette smoking is an important predictor for risk of allcauses of death as well as for cancer deaths. The change of smoking habit during the follow-up period could result in underestimating the deleterious effect of cigarette smoking on health. |
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