壓力及生活因子與胃癌之相關性之病例對照研究

研究目的：探討台灣民眾的壓力及生活型態因子與胃癌發生的關係，以瞭解影響台灣民眾罹患胃癌是否與生活壓力及其他生活型態因子相關。研究背景：胃癌在台灣是發生率及死亡率都相當高的癌症，胃癌的發生是經由複雜的機制，包括生活習慣、飲食等因子所造成，而壓力可能直接或間接引起胃癌的發生。因此，瞭解危險因子及壓力因素對於胃癌發生的相關性並提供國人正確的預防相關資訊，實為台灣公共衛生的重要課題。材料方法：本研究以醫院為基礎的病例對照研究，在中山醫學大學附設醫院及台中榮民總醫院一般外科、家醫科與健康檢查中心進行病例組和對照組的收集，對照組與病例組以年齡與性別進行1：1的配對，共收集病例組與對照組各110人。以結構式問卷為資料收集工具，內容包含基本人口學變項、壓力、生活因子與飲食習慣等，由訪員對受訪者進行訪談。以條件式邏輯斯迴歸等統計方法進行分析，探討壓力與其他生活危險因子及胃癌之交互作用。研究結果：結果顯示醃漬攝取、炸烤醃製肉類食物攝取與海鮮炸烤魚類食物攝取及有胃癌家族史是胃癌發生的危險因子，高度身體活動量與較多的蔬果類食物攝取均可降低罹患胃癌的危險。多變項調整後，高度壓力對於胃癌的發生是危險因子(AOR=4.02，95%CI=2.00-8.07)。壓力與各危險因子的雙變項分析後，在高度壓力下，低身體活動量(OR=13.25，95%CI=3.92-44.81)、高醃漬攝取(OR=6.07，95%CI=3.03-12.15)、炸烤醃製肉類食物攝取多(OR=4.78，95%CI=2.04-11.20)、海鮮炸烤魚肉類食物攝取多(OR=4.89，95%CI=2.09-11.43)、蔬果類食物攝取少(OR=7.01，95%CI=2.68-18.37)等，對於罹患胃癌具有顯著危險。結論：台灣民眾罹患胃癌是因為受到生活型態、遺傳、壓力等多因子的影響，壓力高不僅會增加胃癌發生的危險，也會與其他因子相互影響胃癌的發生。

關鍵字

胃癌；壓力；生活型態

並列摘要

Objective: The purpose of this study is to examine the association among stress, lifestyle factors and the occurrence of gastric cancer in Taiwanese. Background: Gastric Cancer incidence and mortality has gradually increased in Taiwan. The occurrence of gastric cancer is through a complex mechanism with many associated factors, which include life factors and diet. Stress may also directly or indirectly induce gastric cancer. It is important for public health to realize gastric cancer risk factors and their related psychological stress in preventing gastric cancer. Method: This study was based on a hospital-based case-control study of 110 patients with gastric cancer and 110 controls, who did not have cancer. They were matched through age and sex by a 1:1 ratio. Respondent information was collected through face-to-face interviews using structured questionnaires, which included perceived stress, lifestyle factors and dietary habits. Conditional logistic regression analyses was used to analyze the association between the factors and gastric cancer; furthermore, Results: Our results showed that pickled intake, consumption of fried and roast meat，consumption of fried sea food, as well as a family history of gastric cancer were the risks factor of gastric cancer. A high level of physical activity and increased diet of vegetables would reduce the risk of gastric cancer. After adjusting other variables, high levels of stress was concluded to be a risk factor of gastric cancer (AOR=4.02, 95%CI=2.00-8.07). Bivariate interaction analyses showed that there is a significant positive association between high level of stress and gastric cancer in patients who were had low level of physical activity (OR=13.25, 95%CI=3.92-44.81), high level of pickled intake (OR=6.07, 95%CI=3.03-12.15), high consumption of fried and roast meat (OR=4.78, 95%CI=2.04-11.20), high consumption of fried sea food (OR=4.89, 95%CI=2.09-11.43), low level of vegetable consumption (OR=7.01, 95%CI=2.68-18.37). Conclusion: The risk of gastric cancer was associated with lifestyle, genetic factors, and stress in Taiwan. High level of stress will increase the risk of gastric cancer in conjunction with the other risk factors.

並列關鍵字

Gastric cancer ； stress ； life style ； dietary habits

參考文獻

國民健康局 (民80)。中華民國八十年癌症登記報告。行政院衛生署國民健康局。

國民健康局 (民99)。中華民國九十七年癌症登記報告。行政院衛生署國民健康局。

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壓力及生活因子與胃癌之相關性之病例對照研究

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