家庭用煤时间与上消化道癌症和癌前病变之间的关系：一项横断面研究

摘要(中文译文)

探讨家庭燃煤使用年限与上消化道癌及癌前病变之间的关联。本研究为横断面研究。研究对象选自山西省潞城区和平顺县参加上消化道癌筛查且资料完整者。通过标准化问卷收集人口学特征、疾病史、生活方式及家庭燃煤使用情况。采用多因素logistic回归模型评估家庭燃煤使用年限与上消化道癌及癌前病变的关联。按年龄、性别、地区、吸烟状况和饮酒情况进行亚组分析。采用敏感性分析验证结果的稳健性。共纳入55 820名参与者，其中上消化道癌及癌前病变783例，对照55 037例。调整潜在混杂因素后，观察到家庭燃煤使用年限与上消化道癌及癌前病变呈正相关（OR = 1.13，95% CI：1.05-1.24，= 0.003）。分层分析显示，在女性、年龄≥65岁者、非吸烟者、非饮酒者及平顺县居民中关联具有统计学意义。然而，各亚组变量的交互作用检验均无统计学意义（交互作用P值均> 0.05），提示无效应修饰证据。敏感性分析表明所观察到的关联具有稳定性和稳健性。家庭燃煤使用年限与上消化道癌及癌前病变呈正相关。鉴于本研究为横断面研究，无法建立因果推断。有必要开展前瞻性研究以进一步验证这些发现。

Abstract

To explore the association between household coal use duration and upper gastrointestinal cancer and precancerous lesions. This study is a cross-sectional study. The research subjects were selected from those in Lucheng District and Pingshun County of Shanxi Province who participated in the upper gastrointestinal cancer screening and had complete data. The demographic characteristics, disease history, lifestyle, and household coal usage were collected through standardized questionnaires. A multivariable logistic regression model was used to assess the association between the duration of household coal usage and upper gastrointestinal cancer and precancerous lesions. Subgroup analysis was conducted based on age, gender, region, smoking status, and alcohol consumption. Sensitivity analysis was used to verify the robustness of the results. A total of 55,820 participants were included, including 783 cases with upper gastrointestinal cancer and precancerous lesions and 55,037 controls. After adjustment for potential confounders, a positive association was observed between the duration of household coal use and upper gastrointestinal cancer and precancerous lesions (OR = 1.13, 95% CI: 1.05-1.24, = 0.003). Stratified analyses showed statistically significant associations among women, individuals aged ≥65 years, non-smokers, non-drinkers, and residents of Pingshun County. Nevertheless, interaction tests were not statistically significant across all subgroup variables (all for interaction > 0.05), indicating no evidence of effect modification. Sensitivity analyses demonstrated the stability and robustness of the observed association. A positive association was observed between the duration of household coal use and upper gastrointestinal cancer and precancerous lesions. Given the cross-sectional nature of this study, causal inferences cannot be established. Prospective studies are warranted to further validate these findings.

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