2020—2022年凤阳县农村上消化道癌发病现状及相关因素调查

doi:10.12183/j.scjpm.2024.0809

摘要/Abstract

摘要： 目的了解调查凤阳县农村居民上消化道癌发病现状及其危险因素,为制定凤阳县上消化道癌防控策略提供参考依据。方法采用多阶段分层抽样方法,于2020年1月至2022年12月对安徽省凤阳县25个农村地区≥18岁常住农村人口进行上消化道癌初步检查、实验室检测及问卷调查,采用描述性分析方法对凤阳县农村居民上消化道癌发病情况进行分析,使用logistic回归模型对上消化道癌发病的危险因素进行分析。结果本研究共纳入4 532名凤阳县常住农村居民并完成电子胃镜检查和可疑病灶的病理活检,发现上消化道癌81例,检出率为1.79%（81/4 532）。多因素logistic回归分析显示,文化程度（高中以下OR=2.937,高中OR=2.206）、吸烟（OR=3.379）、过量饮酒（OR=2.165）、喜食腌制食品（OR=3.263）、饮茶（OR=0.519）、喜食油炸豆制品（OR=1.689）、萎缩性胃炎（OR=2.337）、幽门螺杆菌阳性（OR=1.910）均是凤阳县农村居民发生上消化道癌的影响因素（均P<0.05）。结论安徽省凤阳县农村居民上消化道癌发生率较高,需加强对存在不良饮食、饮酒习惯、合并萎缩性胃炎及幽门螺杆菌感染的高危人群进行早期筛查和定期体检,从而实现上消化道癌早诊断及早干预。

关键词: 上消化道癌, 农村居民, 流行特征, 影响因素

Abstract: Objective To investigate the incidence and risk factors of upper gastrointestinal cancer in rural residents of Fengyang County, and to provide a reference basis for the development of prevention and control strategies for upper gastrointestinal cancer in Fengyang County. Methods This study employed a multi-stage stratified sampling method, conducting preliminary examinations, laboratory tests, and questionnaires on the rural residents aged 18 and above in 25 rural communities of Fengyang County, Anhui Province, from January 2020 to December 2022. Descriptive analysis was used to analyze the incidence of upper gastrointestinal cancer in rural residents of Fengyang County, and Logistic regression models were used to analyze the risk factors of upper gastrointestinal cancer. Results A total of 4 532 permanent rural residents in Fengyang County completed electronic gastroscopy and pathological biopsy of suspicious lesions, identifying 81 cases of upper gastrointestinal cancer, with a detection rate of 1.79% (81/4 532). Multivariate logistic regression analysis indicated that education level (below high school OR=2.937, high school OR=2.206), smoking (OR=3.379), excessive drinking (OR=2.165), preference for pickled foods (OR=3.263), drinking tea (OR=0.519), preference for fried bean products (OR=1.689), atrophic gastritis (OR=2.337), and Helicobacter pylori positivity (OR=1.910) were influencing factors for upper gastrointestinal cancer in rural residents of Fengyang County. Conclusions The incidence of upper gastrointestinal cancer in rural residents of Fengyang County, Anhui Province, is relatively high. It is necessary to strengthen early screening and regular physical examinations for high-risk groups with poor dietary and drinking habits, combined with atrophic gastritis, and Helicobacter pylori infection, to achieve early diagnosis and intervention of upper gastrointestinal cancer.

Key words: Upper gastrointestinal cancer, Rural residents, Epidemiological characteristics, Influencing factor

中图分类号:

R195

代玉宏, 李化龙, 刘传芳, 李大鹏. 2020—2022年凤阳县农村上消化道癌发病现状及相关因素调查[J]. 华南预防医学, 2024, 50(9): 809-813.

DAI Yuhong, LI Hualong, LIU Chuanfang, LI Dapeng. Incidence and related factors of upper gastrointestinal cancer in rural residents of Fengyang County, 2020-2022[J]. South China Journal of Preventive Medicine, 2024, 50(9): 809-813.

参考文献

[1] Xia C, Dong X, Li H, et al.Cancer statistics in China and United States, 2022: Profiles, trends, and determinants[J]. Chin Med J (Engl), 2022, 135(5): 584-590.
[2] 滕菲,李贺,曹毛毛,等. 基于中国部分农村上消化道癌筛查地区的癌症防治核心知识知晓情况分析[J]. 肿瘤预防与治疗,2020,33(6):493-500.
[3] Nicholson BD, Oke J, Virdee PS, et al.Multi-cancer early detection test in symptomatic patients referred for cancer investigation in England and Wales (SYMPLIFY): A large-scale, observational cohort study[J]. Lancet Oncol, 2023, 24(7): 733-740.
[4] 张瑞,李贺,李霓,等. 基于中国城市大规模人群筛查队列的上消化道癌危险因素巢式病例对照研究[J]. 中国肿瘤,2021,30(5):321-327.
[5] 戴丹,贾尚春,徐伟,等. 2010—2015年安徽省食管癌发病与死亡趋势分析[J]. 中华肿瘤防治杂志,2019,26(22):1663-1668.
[6] 吴寒寒,王陈,汪光军,等. 安徽省某胃癌高发县40~69岁居民食盐及腌渍食物摄入与幽门螺杆菌感染状况的调查与分析[J]. 中华疾病控制杂志,2020,24(2):164-169.
[7] 贾尚春,徐伟,刘荣,等. 2018—2019年安徽省农村居民胃癌筛查检出情况及相关影响因素分析[J]. 中国肿瘤,2020,29(7):503-508.
[8] Han B, Zheng R, Zeng H, et al.Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4(1): 47-53.
[9] Chen W, Li H, Ren J, et al.Selection of high-risk individuals for esophageal cancer screening: A prediction model of esophageal squamous cell carcinoma based on a multicenter screening cohort in rural China[J]. Int J Cancer, 2021, 148(2): 329-339.
[10] 冯祥,印红军,华召来,等. 2020—2021年上消化道癌机会性和门诊及人群筛查结果比较[J]. 中华肿瘤防治杂志,2023,30(8):443-449.
[11] 方三高,魏建国,陈真伟. WHO(2019)消化系统肿瘤分类[J]. 诊断病理学杂志,2019,26(12):865-870.
[12] 尚婕,张梅,赵振平,等. 2013年中国成年人吸烟状况与多种慢性病的关联研究[J]. 中华流行病学杂志,2018,39(4):433-438.
[13] 中国营养学会. 中国居民膳食指南2016[M]. 北京:人民卫生出版社,2016.
[14] 钟文洲,陈正义,王齐全. 原发性肝癌发病危险因素的病例对照分析[J]. 安徽医药,2014,18(2):275-277.
[15] 王姝,莫英绪,彭芳,等. 广西北海地区帕金森病患病率与饮食因素的相关性研究[J]. 中华老年心脑血管病杂志,2018,20(4):417-418.
[16] 中国高血压防治指南修订委员会,中国高血压联盟,中华医学会心血管病学分会,等. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志,2019,24(1):24-56.
[17] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J]. 中华内分泌代谢杂志,2021,37(4):311-398.
[18] Liu CQ, Ma YL, Qin Q, et al.Epidemiology of esophageal cancer in 2020 and projections to 2030 and 2040[J]. Thorac cancer, 2023, 14(1): 3-11.
[19] 戴丹,贾尚春,陈叶纪,等. 安徽省肿瘤登记地区2015年胃癌发病与死亡[J]. 实用肿瘤学杂志,2020,34(1):6-10.
[20] Cao W, Chen HD, Yu YW, et al.Changing profiles of cancer burden worldwide and in China: A secondary analysis of the global cancer statistics 2020[J]. Chin Med J (Engl), 2021, 134(7): 783-791.
[21] 张观坡,叶显宗,江传燊,等. 内镜下萎缩性胃炎分级对胃癌筛查的指导价值[J]. 胃肠病学,2020,25(12):735-739.
[22] 马丹,孟凡冬. 幽门螺杆菌感染与胃癌的早期诊治[J]. 中华内科杂志,2020,59(5):392-394.
[23] Farley H.Promoting self‐efficacy in patients with chronic disease beyond traditional education: A literature review[J]. Nursing Open, 2020, 7(1): 30-41.
[24] 李兆申. 慢性萎缩性胃炎的早筛、早诊、早治与胃癌的预防[J]. 中华消化杂志,2021,41(1):5-8.
[25] 张秋月,李培杰,董全江,等. 胃癌相关幽门螺杆菌毒力和粘附基因进化分析[J]. 中国病原生物学杂志,2021,16(2):161-166.
[26] 周政,刘有理. 上消化道早癌筛查结果和相关因素分析[J]. 现代消化及介入诊疗,2023,28(4):411-414.
[27] 张志宏,崔王飞,王新正,等. 上消化道癌及癌前病变高危人群预测模型研究[J]. 中国癌症防治杂志,2023,15(5):549-555.
[28] 樊桦,李雪,郑乃仁,等. 山东省临朐县参与国家上消化道癌早诊早治项目居民饮酒相关尿蛋白质组学特征[J]. 中华预防医学杂志,2021,55(9):1139-1144.
[29] 孙凯旋,张眉佳,廖成功,等. 中国人群胃癌发病影响因素的Meta分析[J]. 现代肿瘤医学,2022,30(8):1431-1438.
[30] 陈伟霖,黄丽萍,韩煌煌,等. 腌制食品摄入联合吸烟、饮酒与食管癌发病关系病例对照研究[J]. 中国公共卫生,2018,34(5):1-4.
[31] Lin Y, Wu C, Yan W, et al.Sociodemographic and lifestyle factors in relation to gastric cancer in a high-risk region of China: A matched case-control study[J]. Nutr Cancer, 2020, 72(3): 421-430.
[32] 郝瑞婷,钱乐,叶必雄,等. 江苏省射阳县居民饮水情况与胃癌关联的病例对照研究[J]. 中华预防医学杂志,2020,54(8):892-896.