Population Attributable Fractions of Adenocarcinoma of the Esophagus and Gastroesophageal Junction
Population Attributable Fractions of Adenocarcinoma of the Esophagus and Gastroesophageal Junction
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DOI：
10.1093/aje/kwr117
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发表时间：
2011-09-01
影响因子：
5
通讯作者：
Whiteman, David C.
中科院分区：
文献类型：
--
作者：
Olsen, Catherine M.;Pandeya, Nirmala;Whiteman, David C.
肥胖、胃食管反流和吸烟已多次被证明是食道腺癌（EAC）和胃食管交界处（GEJAC）的重要和独立危险因素。然而，很少有人尝试量化与这些潜在可改变因素相关的疾病比例。作者利用2002年至2005年在澳大利亚进行的一项基于人群的病例对照研究的数据，估计了归因于肥胖、胃食管反流症状和吸烟的EAC和GEJAC的人群归因比例。病例为EAC （n = 364）或GEJAC （n = 425）。对照（n = 1,580）从人口登记册中随机抽样。吸烟、体重指数（体重以公斤为单位除以身高以米为单位的平方）和胃食管反流共同占EAC病例的76%（95%可信区间：66,84）和GEJAC病例的69%（95%可信区间：58,78）。单独来看，高体重指数（>= 30）和频繁胃酸反流（>= 1次/周）占EAC的最大比例（分别为23%和36%），吸烟和频繁胃酸反流症状占GEJAC的最大比例（分别为43%和28%）。目前的研究表明，这些癌症可以通过保持健康的身体质量指数、避免吸烟和控制症状性胃食管反流来预防。
Obesity, gastroesophageal reflux, and smoking have repeatedly been shown to be important and independent risk factors for adenocarcinoma of the esophagus (EAC) and of the gastroesophageal junction (GEJAC). There have been few attempts, however, to quantify the proportion of disease associated with these potentially modifiable factors. The authors have estimated the population attributable fraction of EAC and GEJAC attributable to obesity, symptoms of gastroesophageal reflux, and smoking using data from a population-based case-control study conducted in Australia between 2002 and 2005. Cases were patients with EAC (n = 364) or GEJAC (n = 425). Controls (n = 1,580) were randomly sampled froma population register. Combinations of smoking, body mass index (weight in kilograms divided by height in meters squared), and gastroesophageal reflux together accounted for 76% (95% confidence interval: 66, 84) of EAC cases and 69% (95% confidence interval: 58, 78) of GEJAC cases. Individually, high body mass index (>= 30) and frequent acid reflux (>= 1 time/week) accounted for the greatest proportions of EAC (23% and 36%, respectively), and smoking and frequent symptoms of acid reflux accounted for the greatest proportions of GEJAC (43% and 28%, respectively). The present study suggests that these cancers may be largely prevented by maintaining healthy body mass index, avoiding smoking, and controlling symptomatic gastroesophageal reflux.