【作者】 李继华；

【Author】 LI Jihua;Qujing Centers for Disease Control and Prevention;

【机构】 曲靖市疾病预防控制中心；

【摘要】 滇东黔西晚二叠世聚煤区是我国南方煤炭资源最为丰富的地区,1973—1975年全国第一次死因调查发现宣威是我国肺癌死亡率最高地区之一,近年来肺癌危害逐渐扩展至滇东其它地区。本文以文献为基础,结合现场研究数据对滇东地区肺癌流行病学特征和发病因素进行分析。滇东地区发生肺癌风险概率较高,宣威、富源等地肺癌发病率、死亡率是的全国平均水平3~7倍,具有明显的地域特点;男性与女性之间肺癌发病率差别不大,男女比值≤1.5:1,其中女性0-49岁肺癌发病率大于男性;肺癌发病年龄提前10~20岁左右,0~49岁肺癌发病率或死亡率是其它地区5~8倍;不同地理位置相差较大,肺癌发病率或死亡率最高地区与最低地区相差数10倍之多;肺癌病理组织学类型以腺癌为主,其中50岁以下女性腺癌高达54.1%;滇东肺癌与其特殊的地理环境、煤炭资源有关,家庭室内生活燃煤污染暴露、家族聚集性和基因易感性是肺癌较高发病率的主要因素;改炉改灶减低室内污染,有效地降低肺癌发病风险;女性肺癌对煤烟污染、家族聚集性和基因易感性的敏感性远高于男性。就滇东整个地区而言,肺癌危险性仍然是室内污染为主,但较高的男性吸烟率和日益增加的工业污染、职业暴露对部分人群和部分地区产生的危害也不可忽视。随着经济发展和医疗保障水平提高,滇东肺癌发病率在未来一段时间内仍将持续升高。更多还原

【Abstract】 The late permian coal field of eastern Yunnan and weatern Guizhou is the area where coal resource is the richest in the south of China. The first national retrospective survey of death causes in 1973-1975, found that lung cancer mortality rates in Xuanwei county are among the highest in China for both male and female. According to references and the data from field research, we explored the epidemiologic feature and risk factors of lung cancer in eastern Yunnan province. In this area, the probability of getting lung cancer is higher, the incidence and mortality in Xunwei and Fuyuan is 3 to 7 times as high as the national average, and has geographical characteristics:The lung cancer rates are similar in men and women, the sex ratio(M/F) range from 1 to 1.5. the age of onset becomes 10-20 years younger than in the rest of the world, the lung cancer rates ranged from 0 to 49 years is 5-8 times higher than other area.the lung cancer rates in the maximum region is over 10 times higher than the minimum ones. The majority of histologic type of lung cancer is adenocarcinoma(45.5%), squamous cell caraionma and small cell caraionma account for 30.0% and 4.9% respectively, especially, adenocarcinoma take up 54.1% in female under 50 years. The special geography and coal resource has beedn associated with lung cancer risk. the mian factor of high lung cancer rate is exposure to indoor smoky coal emissions, family aggregation and genetic susceptibility, and female has higher sensibility than male.The improvement of household stove can reduce the incidence of lung cancer effectively. Totally, exposure to indoor smoky coal emissions play the most important role in increasing risk of lung cancer. While the higher smoking prevalence among males and the damage coming from the increase of industrial air pollution and occupational lung carcinogens in partial population and region can not be ignored.更多还原