Multiple risk factors associated with arsenic-induced skin cancer: effects of chronic liver disease and malnutritional status.
Multiple risk factors associated with arsenic-induced skin cancer: effects of chronic liver disease and malnutritional status.
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DOI：
10.1038/bjc.1995.22
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发表时间：
1995-01
影响因子：
8.8
通讯作者：
Chen, C J
中科院分区：
文献类型：
--
作者：
Hsueh, Y M;Cheng, G S;Wu, M M;Yu, H S;Kuo, T L;Chen, C J
为了评估慢性砷高流行的台湾村庄居民中砷诱发皮肤癌的患病率和多种危险因素，在1988年9月至1989年3月期间共招募了1571名30岁或以上的受试者。所有这些受试者均由公共卫生护士使用结构化问卷进行了亲自访谈，并采访了1081名研究受试者，其中男性468名，女性613名。 参加体检，参与率为68.8%。皮肤癌的总体患病率高达6.1%，无论男性还是女性，其患病率均随着年龄的增长而增加。皮肤癌患病率与慢性砷暴露之间存在显着的剂量反应关系，以流行区居住时间、饮用高砷自流井水的持续时间、平均砷暴露量（百万分之几）和累积砷暴露量（百万分之一年）为指标。慢性乙型肝炎表面抗原携带者伴有肝功能障碍，皮肤癌的患病率增加。以大量食用干甘薯作为主食为标志的营养不良也与砷诱发的皮肤癌患病率增加显着相关。所有这些风险因素在多元逻辑回归分析中仍然具有统计学显着性。与动物实验一致，研究结果表明肝功能和营养状况可能会影响无机砷的代谢以及随后皮肤癌的发展。
In order to evaluate the prevalence and multiple risk factors of arsenic-induced skin cancer among residents in Taiwanese villages in which chronic arseniasis is hyperendemic, a total of 1571 subjects aged 30 or more years were recruited between September 1988 and March 1989. All of them were interviewed personally by a public health nurse using a structured questionnaire, and 1081 interviewed study subjects, including 468 men and 613 women, participated in physical examination, giving a participation rate of 68.8%. The overall prevalence of skin cancer was as high as 6.1%, showing an increase with age in both men and women. There was a significant dose-response relation between skin cancer prevalence and chronic arsenic exposure as indexed by duration of residence in the endemic area, duration of consumption of high-arsenic artesian well water, average arsenic exposure in parts per million (p.p.m.) and cumulative arsenic exposure in p.p.m.-years. Chronic carriers of hepatitis B surface antigen with liver dysfunction had an increased prevalence of skin cancer. Undernourishment, indexed by a high consumption of dried sweet potato as a staple food, was also significantly associated with an increased prevalence of arsenic-induced skin cancer. All these risk factors remained statistically significant in the multiple logistic regression analysis. Consistent with animal experiments, the findings imply that liver function and nutritional status may affect the metabolism of inorganic arsenic and the development of subsequent skin cancers.