京沪穗三城市空气质量变化及其与肺癌发病的关系

目的 探讨京沪穗三城市空气质量变化情况及其与肺癌发病的关系。方法 收集2003—2009年北京、上海、广州居民肺癌发病率及逐日空气污染指数(air pollution index, API)数据,采用年度变化百分比(annual percent change, APC)法对各城市肺癌发病率进行趋势分析,并运用广义相加模型(generalized additive models, GAMs)构建各城市API及GDP对不同性别肺癌发病率影响的模型。结果 上海及广州的空气质量显著优于北京,各城市API年平均值及污染天数出现轻微波动,整体上呈下降趋势。2003—2009年,京沪穗各城市肺癌的发病粗率均呈上升趋势,而世标率在北京女性、上海男性及广州的男性和女性中出现下降趋势,其中仅上海男性下降趋势有统计学意义(APC=-1.060,P=0.019)。模型分析结果显示,肺癌发病率与GDP和API无相关性(P>0.05),而城市、性别间的差异存在统计学意义,P<0.01。结论 京沪穗三城市API逐渐改善,其变化与肺癌发病率变化无相关性,应进一步完善空气质量监测指标。
Objective To investigate the air quality and its association with lung cancer morbidity in Beijing, Shanghai and Guangzhou. Methods The data of lung cancer morbidity and the data of daily air pollution index (API) in Beijing, Shanghai and Guangzhou were collected between 2003 and 2009. Using the method of annual percent change (APC), the change trends of lung cancer morbidity was reviewed, and generalized additive models (GAMs) were built. The associations of lung cancer morbidity with API, GDP were analyzed. Results The air quality in Shanghai and Guangzhou was significantly better than that in Beijing. The annual averages of API and pollution days appear slight fluctuations in three cities, and the overall trends were declined. From 2003 to 2009 the crude morbidity rates of lung cancer were increasing in three cities. The world standard rates showed downward trends in Beijing females, Shanghai males, Guangzhou males and females, however, only decline trend of Shanghai males was statistically significant (APC=-1.060,P=0.019). Model analysis results showed that there were no significant associations between the morbidity of lung cancer with GDP and API (P>0.05), while the differences between the genders and cities were statistically significant (P<0.01). Conclusion This study found gradual improvement of API and no clear evidences that API changes affect the morbidity of lung cancer in Beijing, Shanghai and Guangzhou