我國女性勞工乳癌發生率、篩檢率及存活率之探討

惡性腫瘤（癌症）自民國71年迄今，一直是國人死因之首位。我國提供民眾乳癌篩檢政策已行之有年，透過早期診斷及適當治療來控制健康問題。然而，我國女性勞工的乳癌發生、篩檢及存活率尚不清楚。因此本研究之主要目的為探討我國女性勞工乳癌發生率、篩檢率及存活率之關聯性。本研究整合勞動部及衛生福利部的健康相關資料庫，建立2010～2018年4,742,717名女性勞工之職業世代，以進行各行業別之癌症篩檢率、發生率與存活率的分析。研究結果發現，全行業別之乳癌年齡標準化發生率自2010年的59.99人／每十萬人逐年攀升至2018年的87.17人／每十萬人，並且在礦業與土石採取業有最高的乳癌發生率（93.7人／每十萬人）。歷年全行業別之乳癌篩檢自2010年至2018年有緩慢上升之趨勢。乳癌全期別發生率較高（所有行業的中位數：77.7人／每十萬人）、篩檢率較低（＜所有行業的中位數：34.7％）的行業為專業、科學及技術服務業、出版、影音製作、傳播及資通訊服務業、金融及保險業、不動產業及支援服務業。罹患乳癌女性勞工曾參與乳癌篩檢的比例從2010年49.41％上升至2018年75.88％。所有行業類別中，以營建工程業之全期乳癌存活率0.78為最低。本研究發現乳癌篩檢可以協助勞工在較早時期發現癌症，以降低後續的癌症死亡率及提高癌症存活率。

關鍵字

乳癌；發生率；篩檢率；存活率

並列摘要

Malignant tumor(cancer)is the first cause of death in Taiwan since 1982. The screening projects for female breast cancer has been conducted to early diagnose and adequately control cancer in Taiwan over years. However, the incidence, screening proportion and survival probability on female breast cancer among workers in Taiwan remains unclear. The objective of this study was to investigate the associations between the incidence, screening proportion and survival probability of female breast cancer with different occupations among workers. We have incorporated databases from Ministry of Labor and Ministry of Health and Welfare to establish an occupational cohort of 4,742,717 female workers during 2010-2018 to evaluate the incidence, screening proportion and survival probability of female breast cancer at different industries. The age-standardized incidence of breast cancer increased from 59.99 per 100,000 person-years in 2010 to 87.17 per 100,000 person-years in 2018 for all-occupation female workers, and the highest one was found in mining and quarrying labors(93.7 per 100,000). We observed an increasing trend in the screening proportion of female breast cancer from 2010 to 2018. Occupations with the higher full-stage incidence(≥ median of all industries: 77.7 per 100,000)but the lower screening proportion(＜ median of all industries: 34.7%) on female breast cancer were professional, scientific and technical activities, information and communication, financial and insurance activities, real estate activities and support service activities. The participating proportion of breast cancer among female workers with the diagnosed breast cancer increased from 49.41% in 2010 to 75.88% in 2018. Among all industries, the lowest survival probability of full-stage female breast cancer (0.78)was observed in construction workers. The present study found that female breast cancer screening can benefit workers to detect cancer at an earlier stage for reducing female breast cancer mortality and improving the survival.