台灣女性罹患肺癌相關因素之探討

摘要 本研究旨在探討內生性及外生性的環境因子和女性肺癌發生之相關性。採病例對照研究法，立意取樣方式，研究設計以中部某醫學中心肺癌患者為病例組共110人，包含女性53人及男性57人;非癌症患者為對照組，包含女性47人及男性53人共100人，進行結構式問卷訪談收集資料。所得資料編碼、建檔，以SPSS for windows 10.0及SAS進行統計分析，結果顯示: 女性在控制年齡和教育程度後1.曾暴露於二手菸者，具2.28倍( 95% 信賴區間 1.05-7.60)罹患肺癌之危險性，並進一步發現二手菸的來源為同事者有差異。2.習慣以炒方式烹調者較其他方式煮食者有3.01倍( 95% 信賴區間 1.13-8.02)罹患肺癌的危險性。3.拜香習慣者具2.94倍( 95% 信賴區間 1.00-8.66)罹患肺癌的危險性。4.初經年齡小於15歲者，具2.95倍( 95%信賴區間 1.26-6.88)罹患肺癌的危險性。5.曾子宮頸病變者有9.44倍(95%信賴區間 1.12-79.90)罹患肺癌的危險性。6. 男性罹患肺癌和職業、嚼檳榔及二等親內家人之健康狀況有關;而女性肺癌和環境暴露、荷爾蒙因子及子宮頸病變有密切關聯性。更進一步，探究於暴露環境因子和子宮頸病變、荷爾蒙因子和子宮頸病變及環境因子和荷爾蒙因子之合併效應下，個別地提升了4.69倍(95%信賴區間 1.51-14.53)、6.32倍(95%信賴區間 1.34-29.90)及3.24倍(95%信賴區間 1.07-5.59) 罹患肺癌之危險性。我們的研究裡可發現二手菸、油煙及拜香暴露和女性肺癌的發生具相關係。有趣的是，初經年齡較早及曾子宮頸病變和女性肺癌的發生有關，這似乎也支持過去學者的研究，人類乳突瘤病毒和台灣非抽菸女性肺癌之發生有著密切的關聯性。 關鍵字: 女性、肺癌、環境暴露、子宮頸病變、人類乳頭瘤病毒

Abstract The purpose of this study is to understand whether endogenous and exogenous environmental factors were associated with female lung cancer incidence. The method is a case-control study by intent sampling. Our study had 110 lung cancer patients including 53 female and 57 male case group and 100 non-cancer control group including 47 female and 53 male non-cancer subjects.The data were collected by processing structive questionaire interview and statistically analyzed by SPSS and SAS. Based on the statistical analysis, the following findings were found: (1) passive smoking exposure having 2.28-fold of risk (the 95% CI, 1.05-7.60), especially passive smoking from colleagues, (2) exposure of stir-frying cooking fumes having 3.01-fold of risk ( 95% CI, 1.13-8.02), (3) incense smoke exposure having 2.94-fold of risk (95% CI, 1.00-8.66), (4) the first menstruate before 15 years old having 2.95 fold (95% CI, 1.26-6.88) of risk, and (5) cervical lesion having 9.44-fold (95% CI, 1.12-79.90) of risk in lung cancer incidence.(6) There is a relationship between occupation, hetel nut, the healthy condition of 2nd-generation family members and male who had lung cancer.The association of environmental exposure, hormone factor and cervicial lesion with female lung cancer. Moreover, the three combination including any one exogenous environmental factor and cervical lesion, hormone factor and cervical lesion and any one exogenous environmental factor and hormone factor, the risk of lung cancer was increased to 4.69 fold (95% CI, 1.51-14.53), 6.32 fold (95% CI, 1.34-29.90) and 3.24 fold (95% CI, 1.07-5.59), respectively. Similar findings such as the association of passive smoking, cooking oil fumes and incinse smokes with lung cancer incidence were also observed in our study. Interesting, the association of early menstruate and cervical lesion with female lung cancer incidence found in this study seems to support the previous finding showing that human papillomavirus infection was associated with nonsmoking female lung cancer in Taiwan. Key words:female, lung cancer, environmental exposure, cervical lesion ,human papilloma virus