摘要
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 1 0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 2 2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 .0 9～ 2 .67)、哺乳 1 .95(1 .54～ 2 .47)、肿瘤家族史 1 .84(1 .63～ 2 .0 8)、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 1 5 .47%、1 5 .1 7%、1 3 .76 % ,若这些因素 5年或 1 0年后的暴露率均下降 2 0个百分点和40个百分点 ,其PARP分别下降至 1 2 .77%、1 1 .32 %、1 2 .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 2 0个百分点和 40个百分点 ,其发病率将分别降低 3 .0 9%、2 .75 %、3 .0 3 %和6 .1 9%、5 .50 %、6 .0 7%。结论 ?
Objective To comprehensively analyse and evaluate the risk factors and to predict the trend of breast cancer in China. Methods Collecting the articles on case control studies related to breast cancer in the last 10 years in China. Calculating the relative 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 referred 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 2.67 ), breast feeding 1.95 ( 1.54 2.47 ), family history of tumor 1.84 ( 1.63 2.08 ) and menstruation 1.65 ( 1.44 1.89 ). The factors with higher PRAP were benign breast lesion, breast feeding, psychological stimulation with PRAR 15.47 %, 15.17 %, 13.76 %,respectively. Their PRAP would have decreased to 12.77 %, 11.32 %, 12.52 % and 9.90 %, 8.74 %, 9.69 % respectively if the exposure rates had decreased 20% and 40% in the next 5 or 10 years. Factors contributing 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 breast cancer would then have become 3.09 %, 2.75 %, 3.03 % and 6.19 %, 5.50 %, 6.07 % respectively if their exposure rate had decreased 20% and 40% in the next 5 or 10 years. Conclusion Decreasing benign breast lesion, avoiding psychological stimulation, advocating on breast feeding seemed to be the effective measures to control the occurrence and development of breast cancer.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2003年第7期611-614,共4页
Chinese Journal of Epidemiology
基金
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 ( 3 1)
