乳癌發生與壓力及其相關因子之病例對照研究

研究目的：探討台灣婦女壓力及其相關因素與乳癌的關係。材料方法：本研究是以醫院為基礎的病例對照研究。收取中山醫學大學附設醫院148名乳癌門診患者及148名非癌症的對照組做為研究對象。研究以結構式問卷由訪員對受訪者進行訪談，並以條件式邏輯斯迴歸及邏輯斯迴歸進行分析。研究結果：婦女暴露於二手菸的環境、長期賀爾蒙使用、攝取較多的炸烤類及蛋白質類食品與有乳癌家族史都會增加罹患乳癌的危險；而較多的身體活動與營養補充劑及蔬果類的攝取則可降低乳癌發生的危險。在壓力部份，有高度壓力時會增加婦女罹患乳癌的危險(OR=1.99，95%CI=1.10-3.61)；但在中度壓力時，對於婦女罹患乳癌則有保護作用(OR=0.53，95%CI=0.29-0.97)。在壓力與其他危險因子對於乳癌發生危險性的分層分析中，有中度壓力以及中度身體活動的婦女，會降低乳癌危險的發生(OR=0.20，95%CI=0.05-0.79)；而有高度壓力以及攝取愈多炸烤類飲食的婦女則會提高乳癌罹患的危險(OR=3.17，95%CI=1.07-9.41)。結論：本研究顯示壓力及其他因素如賀爾蒙使用、飲食及家族史都會影響乳癌的發生。

關鍵字

乳癌；壓力；乳癌危險因子

並列摘要

Objective: The aim of this study is to examine the association between breast cancer and stress and its related risk factors among Taiwanese women. Methods: This is a hospital-based case-control study. Both the case group and the control group consisted of 148 breast cancer patients and 148 healthy controls who were recruited from Chung Shan Medical University Hospital. Detailed information regarding every participant was collected through face-to-face interviews using a structured questionnaire. Statistical analysis was performed by conditional logistic regression and logistic regression in this study. Results: Our results showed that women who exposed to passive smoking, had a history of long-term hormone use, had more fried and protein foods in their diet, and had a family history of breast cancer could increase the risk of developing breast cancer. On the other hand, women who had greater physical activity, took nutrition supplements as well as fruits and vegetables in their diet may reduce the risk of developing breast cancer. Women with high levels of stress had an odds ratio of 1.99 (95% CI=1.10-3.61) for breast cancer. However, women with moderate levels of stress have a protective effect of breast cancer (OR=0.53, 95%CI=0.29-0.97). Bivariate stratified analyses showed the inverse relationship of breast cancer development with moderate levels of stress and moderate physical activity for women (OR=0.20, 95%CI=0.05-0.79), whereas women who have high levels of stress and consumed more fried foods will increase risk of breast cancer (OR=3.17, 95%CI=1.07-9.41). Conclusions: Findings from this study indicate that stress and other factors, such as hormones use, diet, and family history can affect the occurrence of breast cancer.

並列關鍵字

Breast cancer ； stress ； breast cancer risk factors

參考文獻

沈志陽 (民97)。乳癌的分子生物學與分子遺傳學。中華癌醫會誌，24(2)，94-97。

初麗娟和高尚仁 (2005)。壓力知覺對負面心理健康影響：靜坐經驗、情緒智能調節效果之探討。中華心理學刊，47(2)，157-149。

國民健康局 (民89)。中華民國86年癌症登記報告。台北：行政院衛生署國民健康局。

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Ahern TP, Lash TL, Egan KM & Baron JA (2009). Lifetime tobacco smoke exposure and breast cancer incidence. Cancer Causes & Control, 20, 1837-1844.

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乳癌發生與壓力及其相關因子之病例對照研究

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