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台湾地区男性肺癌组织病理型态发生率趋势分析与空气污染之相关性研究

【中文摘要】:背景:儘管台湾30年来吸菸率大幅的下降,但台湾男性肺癌仍未有明显的下降趋势。本研究进行分析1995-2008年之间台湾男性肺癌病理组织型态之发生率与抽菸率之间的关係。
方法:本研究之年龄标準化发生率以世界卫生

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组织所公布的2000年世界人口为计算基础,以年龄-期间-世代模型进行分析,进行观察年龄、期间与世代效果对肺癌趋势的影响。
结果: 1970年代台湾男性吸菸率持续下降,经过30年后台湾男性肺癌仍维持高发生率趋势。而与吸菸弱相关的腺癌发生率已大幅成

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长,完全取代鳞状上皮细胞癌成为最常见的男性肺癌病理组织型态。从本研究的分析结果获知,台湾抽菸率的下降,而男性肺癌高发生率趋势,未来应加入抽菸之外的环境风险因子进行解释台湾的男性肺癌趋势。而空气污染因子以悬浮粒子(PM₁₀)、二氧化硫(SO₂)、臭氧(O₃)普遍上有正相关性。
本研究之结果可作为台湾未来的肺癌预防重点,尤其对于肺癌防治现况而言,除了更严格的菸害防治政策外,仍极需纳入其他的潜在风险因子进行肺癌预防控制,如控制石化工业废气、汽机车废气排放等产生悬浮粒子(PM₁₀)、二氧化硫(SO₂)、臭氧(O₃)空气污染源的活动。
【英文摘要】:Background: Although radical shifts in smoking trends over the past few decades, male lung cancer remains a major cause of cancer deaths in many developed countries, and one of the most important public health issues. This study analyzed the recent trends in male lung cancer incidence rates with smoking prevalence in Taiwan (1995-2008) by histological subtypes.
Methods: Age-standardized incidence rates were computed using WHO (2000) standard population as reference, where age, period and cohort effects are analyzed by Poisson APC models to see how they affect the trend.
Results: Nevertheless smoking prevalence in Taiwan drops since 1976, the male lung cancer incidence rate still increase until 2004, and adenocarcinoma cancer has replaced squamous cell carcinoma as the most common lung cancer subtype. The results suggested that future cancer trends analysis could benefit from the model

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included potential air pollution factors as PM₁₀, SO₂, and O₃.
Contribution: Detail analyses show that the increased incidence cases may not fully explained by the previous studies arguing that Taiwan’s future lung cancer prevention focus should include not only tobacco control but also other possible risk factors as air pollution factors: PM₁₀, SO₂, and O₃.
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