THE JOINT EFFECTS OF 2 FACTORS IN THE ETIOLOGY OF ESOPHAGEAL CANCER IN JAPAN
THE JOINT EFFECTS OF 2 FACTORS IN THE ETIOLOGY OF ESOPHAGEAL CANCER IN JAPAN
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DOI：
10.1136/jech.42.4.355
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发表时间：
1988-12-01
影响因子：
6.3
通讯作者：
SASABA, T
中科院分区：
文献类型：
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作者：
NAKACHI, K;IMAI, K;SASABA, T
在日本琦玉县进行的病例对照研究的基础上，对食管癌的病因学进行了多因素分析。两个因素的联合风险直接从联合分布中计算，遵循二分暴露模型。考虑了三种因素组合模型：两个风险增强因素，两个风险降低因素，以及风险增强和降低因素。我们观察到显着的风险升高，在第一个模型中，所观察到的联合风险是在附近的乘法产品的单个因素的作用风险。最高的比值比约为10或更高，发现与咸食物，过量摄入大米和酗酒的组合。第二个和第三个模型也遵循了风险的乘法修正。在第二种模型中观察到的最低比值比小于0.2，其中水果和生蔬菜，水果和海藻，以及生蔬菜和肉类的组合。在第三个模型中，由增强因子引起的风险增加与风险降低因子的存在成比例地降低。最后，两个因素的剂量-反应关系进行了观察，并被归类为三个典型的模式的风险修改，以下三个暴露水平模型。这些模式可以用个体因素的剂量-反应关系和风险的倍增修正来解释。
A multifactorial approach to the aetiology of oesophageal cancer was made on the basis of a case-control study in Saitama prefecture, Japan. The joint risks of two factors were calculated directly from joint distributions, following a dichotomous exposure model. Three models of factor combinations were taken into account: two risk enhancing factors, two risk reducing factors, and risk enhancing and reducing factors. We observed remarkable risk elevations in the first model, and the observed joint risks were in the neighbourhood of the multiplicative products of single acting risks of individual factors. The highest odds ratios of about 10 or more were found with combinations of salty foods, excessive intake of rice and alcohol abuse. The second and third models also followed a multiplicative modification of risk. The lowest odds ratios of less than 0.2 were observed in the second model, with combinations of fruits and raw vegetables, fruits and seaweed, and raw vegetables and meat. In the third model, the increased risk caused by an enhancing factor was reduced proportionately to the presence of a risk reducing factor. Finally the dose-response relations of two factors were observed and shown to be categorised into three typical patterns of risk modification, following a three exposure level model. These patterns could be explained by both the dose-response relations of individual factors and the multiplicative modification of risk.