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研究生:何佩珊
研究生(外文):Ho Pei-shan
論文名稱:口咽癌流行病學研究
論文名稱(外文):The epidemiology of oropharyngeal cancer
指導教授:蔡吉政蔡吉政引用關係謝天渝謝天渝引用關係葛應欽葛應欽引用關係
指導教授(外文):Tsai Chih-ChengShieh Tien-YuKo Ying-Chin
學位類別:博士
校院名稱:高雄醫學大學
系所名稱:牙醫學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文出版年:2002
畢業學年度:90
語文別:中文
論文頁數:152
中文關鍵詞:咽癌檳榔流行病學原住民客家人閩南人
外文關鍵詞:Oropharyngeal cancerbetel quidepidemiologyaborigineHakkaFukkien
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台灣地區口、咽癌發生趨勢
中文摘要
研究背景: 口、咽癌為全世界常見的癌症之一,本研究的目的即是欲檢驗台灣地區1979-1996年的口、咽癌趨勢。
研究方法: 對各年代的口、咽癌估計標準化發生率,以進行國際比較;利用傳統支世代分析法來表現口、咽癌發生率之出生世代效應,另外以年齡-年代-世代分析法來比較口內癌及咽癌受年齡、年代、世代效應之影響情況
結果: 發現口、咽癌有明顯之上升趨勢,特別是在男性; 而以部位別之分率分布情況來看,男性主要出現上升的口、咽部位主要是在舌、齒齦、口底及頰側,而女性則是以舌癌為主要增加之口、咽癌部位。且在男性我們亦發現存在有明顯之世代效應,1929年以後的出生世代有較明顯之上升趨勢,而且男性的口內癌及咽癌的發生率亦有相當大的差異,此現象在較年輕的族群、較近的年代及較晚的出生世代更加的明顯。
結論: 台灣地區這18年來,口、咽癌的上升趨勢主要是由於酒精及檳榔消耗量增加所引起的,而且菸、酒、檳榔三者的協同作用對口內癌的作用比對咽癌的作用強,甚至可能會縮短口內癌的疾病誘導期。
台灣地區口、咽癌之族群別比較
中文摘要
研究背景: 以全世界來看,台灣地區口、咽癌發生率之上升速度相當快速,但不同族群別卻存在不同的口、咽癌趨勢,本研究的目的即是要了解台灣地區不同族群口、咽癌的疾病率。
研究方法: 本研究對象主要包括台灣地區的三種族群社區,閩南、客家及原住民,以閩南族群社區為參考族群,分別對客家及原住民族群估計其口、咽癌之標準化發生比及死亡比。
結果: 我們發現在高檳榔嚼食原住民地區的口、咽癌發生率比閩南地區高(男性: SMR=1.21, SIR=1.12; 女性: SMR=4.3, SIR=2.62),原住民族群口、咽癌的致死率相當高,特別是在原住民女性。而客家族群的口、咽癌發生率及死亡率皆較參考族群低。
結論: 台灣地區口、咽癌有明顯的族群差異,較高檳榔嚼食盛行率為原住民有高口、咽癌疾病率的主要原因,而原住民地區較高的口、咽癌致死率則可能和低社經地位及較差的醫療資源可近性有關。
The Incidence of Oropharyngeal Cancer in Taiwan
Abstract
Backgroud: Orapharyngeal cancer is the one of the most common cancers in the world. The purpose of this study was to examine the time trends of oropharyngeal cancer from 1979 to 1996 in Taiwan.
Method: Traditional cohort analysis was employed to show the birth-cohort effect of oropharyngeal cancer incidence. Age-period-cohort model analysis was used to examine the age, period, and cohort effect betw
Ethnic Differences in Oropharyngeal Cancer of Taiwan
Abstract
Background: Oropharyngeal cancer incidence of Taiwan is remarkable high in the world. But ethnic difference may exist in pattern of oropharyngeal cancer of Tawain. The purpose of this study was to examine the oropharyngeal cancer pattern among different ethnic groups of Taiwan.
Methods: The population divided into three ethnic groups, which were Fukkien, Hakka, and aboriginal communities. Standardized mortality rate ratios (SMRs), standardized incidence rate ratios (SIRs) and their ratios were estimated among these ethnic groups from 1971-1997.
Results: We found that the oropharyngeal cancer in high betel quid chewing aboriginal group was significantly higher than reference group (male: SMR=1.21, SIR=1.12; female SMR=4.3, SIR=2.62). The aboriginal groups also had an excess oropharyngeal cancer (based on SMR/SIR ratios), especially in aboriginal females. The incidence and mortality rate of oropharyngeal cancer in Hakka was significantly lower than in reference group.
Conclusion: The pattern of oropharyngeal cancer in Taiwan showed ethnic differences. Betel quid chewing might be the major etiology related with the higher oropharyngeal cancer of aboriginal groups, and the excess fatality in aboriginal groups might due to lower socioeconomic status and worse medical access, especially in females.
een intra-oral and pharyngeal cancer.
Result: A significant rising trend in oropharyngeal cancer has been seen in males. From the proportion of subsites, the major increasing subsites were on the tongue and mouth in males, and on the tongue in females. In males, we also found an increasing trend in successive cohorts born after 1929. The incidence of intra-oral cancer of male had a greater increase than pharyngeal cancer in the younger age group, recent time periods, and the late birth cohorts.
Conclusion: The increasing trend of oropharyngeal cancer incidence of Taiwan is likely to be heavily influenced by the rising consumption of alcohol and betel quid, and the effect of these etiologies was more significant on intra-oral cancer in recent periods, later cohorts, and the younger age group.
目 錄
文獻探討
第一章 口、咽癌之分類-------------------------------------------1
第一節 部位分類-------------------------------------------------1
第二節 病理組織型態-------------------------------------------2
第三節 影響口、咽癌存活率之因素-------------------------3
第四節 部位分布-------------------------------------------------4
第二章 口、咽之國際比較---------------------------------------9
第一節 發生率及死亡率之國際比較-------------------------9
第二節 長期趨勢-----------------------------------------------10
第三章 口、咽癌之主要危險因子之探討-------------------14
第四章 口、咽癌之族別差異----------------------------------18
第五章 世代分析法----------------------------------------------19
第一篇 台灣地區口咽癌發生趨勢
中文摘要------------------------------------------------------------23
第一章 前言-------------------------------------------------------24
第二章 研究目的-------------------------------------------------26
第三章 材料及方法 ---------------------------------------------27
第四章 結果-------------------------------------------------------31
第五章 討論-------------------------------------------------------36
圖表------------------------------------------------------------------43
第二篇 台灣地區口咽癌之族群比較
中文摘要------------------------------------------------------------61
第一章 前言-------------------------------------------------------62
第二章 研究目的-------------------------------------------------64
第三章 材料及方法 --------------------------------------------65
第四章 結果-------------------------------------------------------68
第五章 討論-------------------------------------------------------71
圖表-----------------------------------------------------------------80
參考文獻------------------------------------------------------------91
附錄一----------------------------------------------------------------105
附錄二----------------------------------------------------------------106
附錄三----------------------------------------------------------------108
附錄四----------------------------------------------------------------111
附錄五----------------------------------------------------------------119
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