摘要
背景与目的肺癌发病率和死亡率持续攀升,高危人群筛查与早期预防的需求十分迫切。本研究旨在探索多维度生活方式和社会经济地位与肺癌发病的关联及其交互作用,为肺癌高危人群筛查和预防提供科学依据。方法通过问卷调查获得的吸烟、饮酒、锻炼、饮食和睡眠信息构建健康生活方式评分,根据教育、就业和家庭收入信息对社会经济地位进行评估,并使用基因检测数据评估遗传变异风险。进行等比例风险假设检验,应用Cox比例风险模型,分析调整遗传变异风险、年龄、性别、糖尿病、高血压和生活环境评分后,健康生活方式评分和社会经济地位与肺癌的关联,以及各因素之间的交互作用。结果共纳入2006年3月至2010年10月进入队列的样本245,538例,并随访至2022年12月31日,将参与者分为病例组(n=1472)和对照组(n=244,066)。分析结果显示,在调整协变量后,健康生活方式评分和社会经济地位与肺癌发病之间仍存在关联:与高健康生活方式评分的参与者相比,中、低健康生活方式评分的参与者患肺癌的风险显著提高,风险比(hazard ratio,HR)分别为2.12(95%CI:1.86-2.41)和3.36(95%CI:2.82-3.99);与高社会经济地位的参与者相比,中、低社会经济地位的参与者患肺癌的风险显著提高,HR分别为1.29(95%CI:1.13-1.48)和1.67(95%CI:1.46-1.90)。是否吸烟与社会经济地位(Pfor interaction=0.05)、其他4种生活方式(Pfor interaction=0.02)之间存在交互作用。结论本研究发现了多维生活方式及社会经济地位与肺癌发病之间存在关联,以及吸烟与社会经济地位、其他4种生活方式之间的交互作用,为肺癌高危人群筛查和预防提供了科学依据。
Background and objective The incidence and mortality rates of lung cancer remain on the rise,creating an urgent need for screening among high-risk populations and early prevention.This study aims to explore the association and interaction between multidimensional lifestyle,socioeconomic status,and the incidence of lung cancer,and to provide scientific evidence for screening high-risk populations and preventing lung cancer.Methods Healthy lifestyle score was constructed using information on smoking,alcohol consumption,exercise,diet and sleep obtained through a questionnaire survey.Socioeconomic status was evaluated based on information on education,employment,and family income,and genetic testing data were used to assess the risk of genetic variation.A proportional hazards assumption test was conducted,and the Cox proportional hazards model was applied to analyze the associations between healthy lifestyle scores,socioeconomic status,and lung cancer,as well as the interactions among various factors,after adjusting for the risk of genetic variation,age,gender,diabetes,hypertension and the living environment score.Results A total of 245,538 samples that entered the cohort from March,2006 to October,2010 were included and followed up until December 31,2022.The participants were divided into the case group(n=1472)and the control group(n=244,066).The analysis results showed that after adjusting for covariates,there was still an association between the healthy lifestyle score,socioeconomic status,and the incidence of lung cancer:compared with participants with a high healthy lifestyle score,the risk of lung cancer in participants with medium and low healthy lifestyle scores was significantly increased,with hazard ratios(HR)of 2.12(95%CI:1.86-2.41)and 3.36(95%CI:2.82-3.99 respectively;compared with participants with high socioeconomic status,the risk of lung cancer in participants with medium and low socioeconomic status was significantly increased,with HR of 1.29(95%CI:1.13-1.48)and 1.67(95%CI:1.46-1.90)respectively.Moreover,there were interactions between smoking status and socioeconomic status(Pfor interaction=0.05),as well as the other four lifestyle factors(Pfor interaction=0.02).Conclusion This study identified the association between multidimensional lifestyle factors and socioeconomic status with the incidence of lung cancer,as well as interactions between smoking and socioeconomic status and four other lifestyle factors,providing a scientific basis for screening and prevention in high-risk populations for lung cancer.
作者
刘昊天
杨润煌
张海平
吕世云
高勃
陶丽新
罗艳侠
郭秀花
Haotian LIU;Runhuang YANG;Haiping ZHANG;Shiyun LV;Bo GAO;Lixin TAO;Yanxia LUO;Xiuhua GUO(School of Public Health,Capital Medical University,Capital Medical University,Beijing 100069,China;Beijing Key Laboratory of Environment and Aging,Capital Medical University,Beijing 100069,China;National Institute for Data Science in Health and Medicine,Capital Medical University,Beijing 100069,China)
出处
《中国肺癌杂志》
北大核心
2025年第7期497-505,共9页
Chinese Journal of Lung Cancer
关键词
肺肿瘤
多维生活方式
社会经济地位
COX比例风险模型
Lung neoplasms
Multidimensional lifestyle
Socioeconomic status
Cox proportional hazards model
作者简介
通信作者:郭秀花,E-mail:guoxiuh@ccmu.edu.cn。
