Study On Impact Factors Of Esophageal Cancer Among Residents In Ningyang County Of The Main Trunk-stream Areas Of Dawen River, Shandong Province, China

【Background】The malignant tumor is one of the important diseases that serious influenced human health and threatened human life.The World Health Organization and the government Medical department in every country list tumor prevention as an important task.The downstream area along Dawen River in Shandong Province is one of high occurrence area of tumors.The morbidity situation of the upper digestive tract cancer prior to esophageal cancer is very stern.Launch research on the risk factors of the malignant tumor and decrease the disease incidence rate and the mortality rate become to be a realistic question,which local governments and people urgent need to solve.Applying the description and case-control study,as well as the analysis to local trace element content,the study explored the morbidity situation of esophageal cancer and the risk factors along Dawen River,in order to provide the scientific basis to prevent and control tumors comprehensively.Part 1 The death situation of esophageal cancer among residents in Ningyang of the main trunk-stream aeas of Dawen river during the year 2004 to 2005【Objective】To describe the death data during the year 2004 to 2005 in high occurrence area of esophageal cancer along Dawen river,and analyze the local esophageal cancer morbidity situation and the change tendency with the correlation data.【Method】The researched basic data was from death registration of the third national investigation of death cause in the year 2006,the case classification followed the ICD-10,the code of international disease classification.Average population by age group during the year 2004 to 2005 was estimated by the data from the Police and the Stat Department of Ningyang,as well as the gender and age structure according to the national population census material in the year 2000.The incidence rate was adjusted according the Chinese standard population constitution in the year 2000 to compare incidence rate and the change tendency of esophageal cancer during the year 2004 to 2005 separately.【Results】The crude mortality rate of esophageal cancer was 64.57 per 100,000, and the standard mortality rate was 63.98 per 100.000.The death of esophageal cancer took up 35.63%of total death of tumor,and was the first cause of death.1.The towns(Dongzhuang,Ciyao,Huafeng,Jiangji,Heshan,Gangcheng, Fushan) along the river in the main trunk-stream areas of Dawen river.The crude mortality rate of esophageal cancer was 59.67 per 100,000 population, while the towns(Geshi,Dongshu,Ningyang,Xiangyin,Sidian) always from the river in the main trunk-stream areas of Dawen river.The crude mortality rate of esophageal cancer was 76.53 per 100,000.2.The towns(Dongzhuang,Ciyao,Huafeng,Jiangji) upper the river in the main trunk-stream areas of Dawen river,The crude mortality rate of esophageal cancer was 34.36 per 100,000,while the towns(Heshan,Gangcheng,Fushan) downstream the river in the main trunk-stream areas of Dawen river,The crude mortality rate of esophageal cancer was 97.39 per 100,000.3.The median age of the death of esophageal cancer was 68(the male was 65, the female was 69) in Ningyang.In all age group,the male's mortality rate of esophageal cancer was higher than the female.Both the male and the female's mortality rate were highten with the age.The age group blow 30 has no esophageal cancer,after 35 years old,the mortality rate of esophageal cancer rise roket,while the male after 45 and the female after 55,the mortality rate of esophageal cancer surpassed 100 per 100,000.Almost 90%case death after 40 years old,while the masimum was in 65-75 years old,nearly to 15%of all death.【Conclusions】The downstream area of main trunk-stream of Dawen river was the high occurrence area of esophageal cancer,the mortality rate of the upside country was higher than the downside country,and the mortality rate apart from the river was higher than the country along the river.The mortality rate of esophageal cancer in the main trunk-stream of Dawen river prent an obvious areas accumulation.Part 2 Case-control study on the impact factors of esophageal cancer among residents【Objective】To explore the impact factors of esophageal cancer along the main trunk-stream areas of Dawen river in Shandong province.【Method】By the method of population-based case-control study,the epidemiological data about esophageal cancer was collected in Ningyang lied in the main trunk-stream of Dawen river.According to the incidence report registration information from 2005 to 2006,the new survival patients were chosen as the cases. Gender,age and place of residence were used as the match conditions.The logistic model was fitted by controlling the hybrid factors.And single-and multi-factors analysises were used to analysis the relationship between exposure factors and esophageal cancer.In addition,the colinerarity factors were removed with the colinerarity analysis.【Results】1.Single-factors analysis:According to single-factors analysis with P＜0.1,the results indicated that lower income;more indoor cooking fumes,removed some food mildew before eating,tasted salty,dry and hard eating,self-made tobacco, alcohol＞500 ml/day,drinking alcohol with xihu,poor self-regulation emotional, difficult to adapt to environmental,and family history of cancer had statistically significants,All these described above may be the risk factors.While the regular consumption of Congjiang Suan and the tea inspection may be the protective factors for esophageal cancer(P＜0.1).There was no significant difference in low literacylevels,rinking water＞20 years,regular consumption of Pancakes, regular consumption of Rezhou,often fasting drinking,B model personality,and other factors(P＞0.10).2.Linear analysis:Using multiple linear regression analysis with the SAS procedures,the tolerance(tolerance,TOL) statistical checked Multi-linear problems of the 19 independent variables.All tolerance index values were greater than 0.20,so that all the 19 independent variables did not exist the Multi-linear problems.3.Multi-factors analysis:The results in multi-factors analysis(P＜0.1) were enter the regression model for Logistic regression analysis according to sle=0.3 and sls=0.2.The results showed that drinking tea(P=0.002,OR=0.311) may be a protective factors for esophageal cancer,while dry and hard eating(P=0.040, OR=5.850),Self-made tobacco(P=0.003,OR=16.158),alcohol consumption of＞500ml/day(P=0.045,OR=11.513),family history of cancer(P=0.044, 0R=1.827) may be risk factors for esophageal cancer.【Conclusions】In the main trunk-stream of Dawen river,the high incidence of esophageal cancer was not only related with the environment and dietary factors,but also with the family history of esophageal cancer.More study should be conducted in-depth and take comprehensive prevention and control measures on esophageal cancer. Part 3 Comparative analysis on the relationship between accumulation of esophageal cancer and the trace element content along the Main-Trunk-stream Areas of Dawen River【Objective】To analyze the relationship between the esophageal cancer and the trace element in water and foodstuff along the main trunk-stream of Dawen river.【Method】Base the result of investigate of cancer from 1970 to 1974.chose Ningyang and Xintai as the investigate object by the difference of esophageal cancer mortality rate.To explore the relationship between the tutor incidence rate and the trace element content of local drinking water and grain.【Results】The high occurrence phenomenon of esophageal cancer was existed in the main valley along the main trunk-stream of Dawen River,most accumulated in country Ningyang along the downstream of the Dawen River.Significant differences of copper,zinc,manganese,iron,calcium in grain and drinking water were observed from different morbidity areas in upstream and downstream.1.Trace elements in wheat after t-test showed that Mn and Fe had a statistically significant(P＜0.05) between the upstream and downstream of the main trunk river.Mn and Fe of the lower reaches were significantly higher than the upper reaches.In addition,Ca along the river was less than the remote areas,and difference was statistically significant(P＜0.05).2.Trace elements in maize after t-test showed that Cu,Zn and Ca had statistically significants(P＜0.05) between the upstream and downstream of the main trunk river,Cu of the lower reaches were significantly higher than the upper reaches,while Zn and Ca were in contrast.Fe along the river was less than the remote areas,and difference in the test was statistically significant (P＜0.05).3.The drinking water in all areas had no statistically significant(P＞0.05) alter t-test.【Conclusions】The study suggested that local accumulation exist in the esophageal cancer along the main trunk-stream of Dawen river;geological and environmental influence was probably an important factor on the area difference of esophageal cancer.