| 方亚,施侣元.乳腺癌危险因素综合评价及其趋势预测[J].Chinese journal of Epidemiology,2003,24(7):611-614 |
| 乳腺癌危险因素综合评价及其趋势预测 |
| Comprehensive evaluation and trend prediction of risk factors on breast cancer |
| Received:November 08, 2002 |
| DOI： |
| KeyWord: 乳腺肿瘤 危险因素 评价 预测 |
| English Key Word: Breast neoplasms Risk factor Evaluation Prediction |
| FundProject:卫生部慢性非传染性疾病预防与控制专题研究基金资助项目(31) |
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| Abstract: |
| 目的 综合分析评价中国乳腺癌的危险因素并预测其发展趋势.方法 收集近10年来国内有关乳腺癌危险因素的病例对照研究文献,采用Meta分析的随机效应模型,计算有关危险因素的OR值及其95 %CI,找出乳腺癌的主要危险因素;结合人群暴露率,估计目前和预测未来的人群归因危险度百分比(PARP);估计暴露率的变化,预测未来5年乳腺癌发病率的变化.结果 共筛选出相关文献22篇.前5位乳腺癌危险因素及OR值(95 %CI)依次为 :良性乳腺疾病 3.39(2.97～3.86)、生活精神刺激2.36(2.09～2.67)、哺乳1.95(1.54～2.47)、肿瘤家族史1.84(1.63～2.08)、月经周期1.65(1.44～1.89);获得较大PARP的因素依次为良性乳腺疾病、哺乳、生活精神刺激,其目前PARP分别为15.47%、15.17%、1 3.76%,若这些因素5年或10年后的暴露率均下降20个百分点和40个百分点,其PARP分别下降至12.77%、11.32%、12.52%和9.90%、8.74%、9.69%;随着暴露率的改变,乳腺癌的发病率亦将发生改变,其中贡献较大的因素依次是良性乳腺疾病、哺乳、生活精神刺激,如暴露率下降20个百分点和40个百分点,其发病率将分别降低 3.09%、2.75%、3.03%和6.19%、5.50%、6.07%.结论 控制中国人群乳腺癌的发生及发展,应从降低良性乳腺疾病、避免生活精神刺激和提倡母乳喂养几个方而积极采取有效措施. |
| English Abstract: |
| Objective To comprehensively analyse and evaluate the risk factors and to predict the trend of breast cancer in China. Meth-ods Collecting the articles on case-control studies related to breast cancer in the last 10 years in China. Calculating the rela-tive risk(OR)and 95%confidence interval(95% CI)of risk factors by the random effect model of Meta-analysis to estimate present and future population attributable risk percent(PARP) based on the exposure rate of risk factor and to predict the change of
incidence rates of breast cancer during the following 5 years with the change of exposure rates.Results Twenty-two articles re-ferred to case-control studies on breast cancer were selected. The OR and its 95%CI of the first 5 risk factors of breast cancer in China were benign breast lesion 3.39(2.97-3.86),psychological stimulation 2.36(2.09一2.67)，breast-feeding 1.95(1.54一2.47),family history of tumor 1.8401.63-2. 08 ) and menstruation 1.65 Cl.44-1.89).The factors with higher PRAP were benign breast lesion breast f-eeding psychological stimulation with PRAR 15.47%，15.17%,13.76%，respectively.Their PRAP would have decreased to 12.77,11.3%,12.52% and 9.90，8.74%,9.69%respectively if the exposure rates had decreased 20%and40% in the next 5 or 10 years.Factors con-tributing to the change of incidence rate of breast cancer would include benign breast lesion breast-feeding psychological stimulation along with the change of exposure rate. The incidence rates of breastcancer would then have become 3.09%，2.75%,3.03%and 6.19%, 5.50%, 6.07% respec-tively if theirexposure rate had decreased 20% and 40% in the next 5 or 10 years.Conclusion Decreasing b-enign breast lesion avoiding psychological stimulation advocating on breast-feeding seemed to be the effective measures to control the occurrence and dev-elopment of breast cancer. |
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