ADENOCARCINOMA OF THE ESOPHAGUS AND ESOPHAGOGASTRIC JUNCTION IN WHITE MEN IN THE UNITED-STATES - ALCOHOL, TOBACCO, AND SOCIOECONOMIC-FACTORS
ADENOCARCINOMA OF THE ESOPHAGUS AND ESOPHAGOGASTRIC JUNCTION IN WHITE MEN IN THE UNITED-STATES - ALCOHOL, TOBACCO, AND SOCIOECONOMIC-FACTORS
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DOI：
10.1007/bf01804984
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发表时间：
1994-07-01
影响因子：
2.3
通讯作者：
HOOVER, RN
中科院分区：
文献类型：
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作者：
BROWN, LM;SILVERMAN, DT;HOOVER, RN
在美国，食道腺癌的发病率，包括食管胃（EG）交界处，在过去的二十年里一直在迅速增加。除了与巴雷特食道有关外，对这些癌症的病因知之甚少。一项以人群为基础的病例对照访谈研究，对生活在美国三个地区的174名患有食道腺癌的白人男性和750名对照组进行了研究，为调查这些癌症与吸烟、饮酒、社会经济因素和溃疡史的关系提供了机会。吸烟（优势比[OR] = 2.1）或饮酒（OR = 1.6）的男性患乳腺癌的风险显著增加。吸烟和饮酒都有显著的剂量梯度。戒烟后未观察到风险降低。从无过滤嘴香烟换成有过滤嘴香烟的受试者的风险是只抽无过滤嘴香烟的人的一半。随着最近年收入的增加，风险梯度呈负相关，最低类别的风险最高（OR = 3.4）。有溃疡史的风险（OR = 1.7），尤其是十二指肠溃疡（OR = 2.2）也显著升高。这些数据表明，烟草和酒精可能是食道和EG交界处腺癌的病因，但这些因素似乎并不能解释这些肿瘤发病率的迅速上升。与低社会阶层和溃疡史的关系需要与其他可能解释食管癌时间趋势的因素一起进行更详细的探讨。
In the United States, the incidence of adenocarcinoma of the esophagus, including the esophagogastric (EG) junction, has been increasing rapidly over the past two decades. Except for an association with Barrett's esophagus, little is known about the etiology of these cancers. A population-based case-control interview study of 174 White men with adenocarcinoma of the esophagus and 750 controls living in three areas of the United States offered the opportunity to investigate the relationship of these cancers with smoking, alcohol drinking, socioeconomic factors, and history of ulcer. There were significantly elevated risks for men who smoked cigarettes (odds ratio [OR] = 2.1) or drank liquor (OR = 1.6). For both cigarette smoking and liquor drinking, there were significant dose gradients with amount consumed. No reduction in risk was observed following smoking cessation. Subjects who switched from nonfilter to filter cigarettes experienced half the risk of those who only smoked nonfilter cigarettes. Inverse risk gradients were seen with increasing recent annual income, with the highest risk (OR = 3.4) for the lowest category. The risk for a history of ulcer (OR = 1.7), especially of the duodenum (OR = 2.2), was also significantly elevated. These data suggest that tobacco and alcohol may be etiologic factors for adenocarcinoma of the esophagus and EG junction, but these factors do not appear to explain the rapid rise in incidence of these tumors. The associations with low social class and history of ulcer need to be explored in greater detail along with other factors that may account for the temporal trends in esophageal adenocarcinomas.