Lancet:女性身高与癌症发病率（前瞻队列研究meta分析）
2011-07-28 12:10:36   来源：   作者：  评论：0 点击：

流行病学研究显示，海拔高的人患癌风险较大，但这个与身高相关的患癌风险是否与癌症发生部位或其他因素，如吸烟及社会经济状况等因素有关却尚不明确。我们的研究目的是在英国展开大规模前瞻性队列研究，通过直接比较身高相关的患癌风险与癌症发生部位的关系，探讨患癌的主要的混杂因素及调控因素。

Methods
Information on height and other factors relevant for cancer was obtained in 1996—2001 for middle-aged women without previous cancer who were followed up for cancer incidence. We used Cox regression models to calculate adjusted relative risks (RRs) per 10 cm increase in measured height for total incident cancer and for 17 specific cancer sites, taking attained age as the underlying time variable. We also did a meta-analysis of published results from prospective studies of total cancer risk in relation to height.
我们收集了1996年到2001年此前未患癌症的中年妇女与癌症相关的信息如身高和其他相关因素，并对其进行针对癌症发生的随访。使用Cox回归分析模型计算每增加10厘米身高的校正相对危险度，测量身高对总体患癌风险的贡献水平。我们观察了17个相关的患癌部位，年龄作为时间变量。同时，我们对已经发表的关于身高相关的总体患癌风险的前瞻性研究结果进行了meta分析。

Findings
1 297 124 women included in our analysis were followed up for a total of 11·7 million person-years (median 9·4 years per woman, IQR 8·4—10·2), during which time 97 376 incident cancers occurred. The RR for total cancer was of 1·16 (95% CI 1·14—1·17; p<0·0001) for every 10 cm increase in height. Risk increased for 15 of the 17 cancer sites we assessed, and was statistically significant for ten sites: colon (RR per 10 cm increase in height 1·25, 95% CI 1·19—1·30), rectum (1·14, 1·07—1·22), malignant melanoma (1·32, 1·24—1·40), breast (1·17, 1·15—1·19), endometrium (1·19, 1·13—1·24), ovary (1·17, 1·11—1·23), kidney (1·29, 1·19—1·41), CNS (1·20, 1·12—1·29), non-Hodgkin lymphoma (1·21, 1·14—1·29), and leukaemia (1·26, 1·15—1·38). The increase in total cancer RR per 10 cm increase in height did not vary significantly by socioeconomic status or by ten other personal characteristics we assessed, but was significantly lower in current than in never smokers (p<0·0001). In current smokers, smoking-related cancers were not as strongly related to height as were other cancers (RR per 10 cm increase in height 1·05, 95% CI 1·01—1·09, and 1·17, 1·13—1·22, respectively; p=0·0004). In a meta-analysis of our study and ten other prospective studies, height-associated RRs for total cancer showed little variation across Europe, North America, Australasia, and Asia.
1 297 124 名妇女进入了我们的研究分析，随访共进行了11.7百万人年（中位数为9.4人年/人， IQR 8.4-10.2），在这期间， 有97 376 例新发个案。每增加10厘米身高的总体患癌的相对危险比为1.16（95%置信区间为1.14-1.17，p<.0001）。在17个接受评估的患癌部位中有15个相对危险度有上升，其中有10个部位患癌风险的上升具有统计学差异：结肠（每增加10厘米身高的相对危险比为1.25，95%置信区间为1.19-1.30），直肠（1.14，1.13-1.24），卵巢（1.17，1.11-1.23），肾脏（1.29，1.19-1.41），中枢神经系统（1.20，1.12-1.29），非霍奇金淋巴瘤（1.21，1.14-1.29），白血病（1.26，1.15-1.38）。在纳入评估的社会经济状况与其他10个相关的个人特征，每上升10厘米身高所增加的总体患癌相对风险比不具有统计学差异，但不吸烟的人群其发病风险显著降低（p<.0001）。对于现正吸烟的人群，吸烟相关的肿瘤发生率与身高之间的关联比与吸烟无关的肿瘤和身高关联性明显降低（吸烟相关肿瘤：每增加10厘米身高相对危险比为1.05，95%置信区间为1.01-1.09；吸烟无关肿瘤：1.17，1.13-1.22；p=.0004）。对我们的研究与其他10个相关的前瞻性研究进行了meta分析后，身高相关的患癌总体相对危险比在欧洲、北美、澳大利亚及亚洲并无显著的差异。

Interpretation
Cancer incidence increases with increasing adult height for most cancer sites. The relation between height and total cancer RR is similar in different populations.
在成年人多数患癌部位，患癌风险随年龄增长而增加。身高与总体患癌相对危险比在不同人群中相似。

Funding
Cancer Research UK and the UK Medical Research Council.
本项目由英国癌症及医学研究基金资助。