Prevalence of Opisthorchis viverrini infection and incidence of cholangiocarcinoma in Khon Kaen, Northeast Thailand
Prevalence of Opisthorchis viverrini infection and incidence of cholangiocarcinoma in Khon Kaen, Northeast Thailand
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DOI：
10.1111/j.1365-3156.2004.01234.x
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发表时间：
2004-05-01
影响因子：
3.3
通讯作者：
Parkin, DM
中科院分区：
文献类型：
--
作者：
Sriamporn, S;Pisani, P;Parkin, DM
肝癌是泰国东北部孔敬最常见的癌症，因为胆管癌（CHCA）的发病率很高。猫尾后睾吸虫（OV）是该地区的一种地方性肝吸虫，已被国际癌症研究机构评估为CHCA的病因。1990年至2001年，该省20个县的居民应邀参加了一个移动的检查方案。在24723名参与者中，有18393名年龄在35-69岁之间的人通过检查粪便中是否存在卵来检测OV感染。每个地区的感染率是根据接受检测的人口抽样估计的。1990-2001年肝癌发病率是从癌症登记处获得的。样本人群OV感染率平均为24.5%，不同地区的OV感染率从2.1%到70.8%不等。年龄>35岁的CHCA的截断年龄标准化发病率在地区之间变化三倍，从每10万人年93.8到317.6。经年龄、性别和采样时间调整后，人群水平上OV感染率与CHCA发病率呈正相关。由于有效的抗OV治疗，CHCA和个体活动性OV感染之间的关联已变得难以证明。然而，在人群之间的比较中，这种关系可能是明确的，对于传染病，在确定个人结果时考虑到群体暴露的背景影响。癌症登记是小地区疾病监测的适当工具。
Liver cancer is the most common cancer in Khon Kaen, Northeast Thailand, because of the high incidence of cholangiocarcinoma (CHCA). Opisthorchis viverrini (OV), a liver fluke, is endemic in the area, and has been evaluated as a cause of CHCA by International Agency for Research on Cancer. Residents of 20 districts in the province were invited to attend a mobile screening programme between 1990 and 2001. Of 24 723 participants, 18 393 aged 35-69 years were tested for OV infection, by examining stools for the presence of eggs. Prevalence of infection in each district was estimated from the sample of the population who had been tested. The incidence of liver cancer in 1990-2001 was obtained for each district from the cancer registry. The average crude prevalence of OV infection in the sample subjects was 24.5%, ranging from 2.1% to 70.8% in different districts. Truncated age-standardized incidence of CHCA at ages >35 years varied threefold between districts, from 93.8 to 317.6 per 100 000 person-years. After adjustment for age group, sex and period of sampling, there was a positive association between prevalence of OV infection and incidence of CHCA at the population level. Associations between CHCA and active OV infection in individuals have become hard to demonstrate, because of effective anti-OV treatment. The relationship may, however, be clear in comparisons between populations, which, for infectious diseases, take into account the contextual effects of group exposure in determining individual outcome. The cancer registry is an appropriate tool for disease monitoring in small areas.