文章摘要
查震球,李蕊,胡明军,戴丹,宋律,黄芬,刘志荣.吸烟状况与胃癌患者发病年龄及其直接医疗费用的关系分析[J].中华流行病学杂志,2020,41(9):1482-1486
吸烟状况与胃癌患者发病年龄及其直接医疗费用的关系分析
Analysis on the relationship between smoking status and the onset age of onset and the direct medical expenditure expenses of gastric cancer patients
收稿日期:2019-09-27  出版日期:2020-09-18
DOI:10.3760/cma.j.cn112338-20190927-00706
中文关键词: 胃癌;吸烟;危险因素;直接医疗费用
英文关键词: Stomach cancer;Smoking;Risk factors;Direct medical expenses
基金项目:国家重点研发计划(2017YFC0908103,2016YFC1302605);安徽省重点研发计划(1704a0802156);国家自然科学基金(71804002)
作者单位E-mail
查震球 安徽省疾病预防控制中心, 合肥 230601  
李蕊 安徽省疾病预防控制中心, 合肥 230601  
胡明军 安徽医科大学流行病与卫生统计学系, 合肥 230032  
戴丹 安徽省疾病预防控制中心, 合肥 230601  
宋律 安徽省疾病预防控制中心, 合肥 230601  
黄芬 安徽医科大学流行病与卫生统计学系, 合肥 230032  
刘志荣 安徽省疾病预防控制中心, 合肥 230601 liuzhirong66@126.com 
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中文摘要:
      目的 探讨吸烟状况与安徽省胃癌患者发病年龄间的风险关联,同时估算因吸烟导致的胃癌直接医疗费用负担。方法 收集2017年安徽省10个肿瘤登记地区的新发胃癌患者及其入院治疗的直接医疗费用信息。通过单因素回归分析和多因素logistic回归模型,分析吸烟状况与胃癌患者发病年龄的关系。使用中位数和吸烟归因危险度法描述安徽省归因于吸烟的胃癌直接医疗费用。结果 本次研究共分析736例胃癌患者资料。单因素回归分析提示,农村户口(t=2.091,P=0.037)、吸烟(t=-2.357,P=0.001 9)和饮酒(t=-2.036,P=0.042)与胃癌患者发病年龄提前有关。在校正性别、饮酒、BMI和户籍类型后,戒烟者提前发生胃癌的风险低于吸烟者(OR=0.36,95% CI:0.17~0.75)。2017年安徽省肿瘤登记地区736例新发胃癌患者归因于吸烟的总直接医疗费用负担为693.96万元,具有吸烟行为的胃癌患者的直接医疗费用高于戒烟和不吸烟的胃癌患者。结论 吸烟是安徽省胃癌发病年龄提前的危险因素之一,安徽省政府部门应加强控烟措施,降低胃癌患者的经济负担。
英文摘要:
      Objective To investigate the relationship between smoking status and the onset age of stomach cancer patients and estimate the patients' direct medical cost burden of stomach cancer due to smoking in Anhui province. Methods The information about the primary stomach cancer patients and their direct treatment expenditures in 10 cancer-registered areas in Anhui were collected in 2017. The association between smoking status and the age of onset of stomach cancer patients was analyzed by univariate regression and multivariate logistic regression models. The median and smoking-attributed risk method was used to describe the direct treatment expenditure of stomach cancer patients in Anhui due to smoking. Results A total of 736 patients with stomach cancer were analyzed in this study. Univariate regression analysis showed that rural household registration (t=2.091, P=0.037), smoking (t=-2.357, P=0.001 9) and alcohol consumption (t=-2.036, P=0.042) were related to the age of onset of stomach cancer. After adjusting for gender, alcohol consumption, body mass index and household registration type, the risk of early stomach cancer in people who quitted smoking cessation was lower than that in smokers (OR=0.36, 95% CI: 0.17-0.75). The total direct medical cost burden of 736 newly diagnosed stomach cancer patients was 6.939 6 million RMB. The direct medical expenditure in stomach cancer patients who had smoking behavior was higher than that in stomach cancer patients who quitted smoking and never smoked. Conclusions Smoking is one of the risk factors for the earlier onset of stomach cancer in Anhui. It is necessary to strengthen tobacco control to reduce the economic burden of patients with stomach cancer.
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