臺灣地區1996-2002年攝護腺癌發生和盛行比較

Abstract

本研究以國家衛生研究院發行之全民健康保險資料庫歸人檔分析台灣1996年至2002年七年間攝護腺癌(prostate cancer，PCA)及良性攝護腺腫大(benign prostatic hyperplasia，BPH)患者的疾病率與醫療情況，並探討良性攝護腺腫大與攝護腺癌的關係。 本研究之重要研究結果如下：就醫院所在地來分析，攝護腺癌患者在台北地區就醫的比例最高，共有103人、佔45.98%；而攝護腺腫大患者在其他地區就醫的比例最高，共有2445人、佔43.13%。 1996-2002年七年間平均的地區別攝護腺癌年齡標準化盛行率由高而低依序是：台北市為35.3×10-5，高雄市為31.8×10-5，台中市為24.4×10-5，其他地區為28.5×10-5，與都市化程度成正相關。1996-2002年七年間平均的地區別良性攝護腺腫大粗盛行率由高而低依序是：其他地區為1011.0×10-5，台北市為813.8×10-5，高雄市為740.8×10-5，台中市為574.7×10-5。另外由邏輯氏迴歸求出居住在台北地區得攝護腺癌的勝算比是居住在其他地區的1.7倍（95%可信賴區間＝1.3－2.3）。 本研究亦選擇世代研究法探討良性攝護腺腫大是否為攝護腺癌的危險因子，得到相對危險性15.7。另以邏輯式迴歸分析1996-2002年歸人檔資料探討良性攝護腺腫大與攝護腺癌的關係，結果得到良性攝護腺腫大患者得攝護腺癌的勝算比是非良性攝護腺腫大患者的19.0倍（95%可信賴區間＝13.1－27.6）。提供流行病學的證據證明良性攝護腺腫大為攝護腺癌的危險因子ㄧ。但無法了解良性攝護腺腫大對攝護腺癌的致病機轉，因此需更進一步生物醫學的研究如、病理學細胞毒性、動物實驗才能釐清BPH對PCA的致病關係。

This study analyze the morbidity、the utilization pattern and the relation of prostate cancer（PCA）and benign prostatic hyperplasia（BPH） in Taiwan. The study sample were selected from NHI Registry for Beneficiaries’ Database from 1996 to 2002.Major findings of this study are as followed: For PCA, Taipei is the highest rate to seek medical advice（103 persons, 45.98%）；For BPH, other areas is the highest rate to seek medical advice（2445 persons, 43.13%）.The age standardization prevail rate of PCA：Taipei is 35.3×10-5, Kaohsjung is 31.8×10-5, Taichung is 24.4×10-5 , other area is 28.5×10-5, it is positive correlation with the urbanization degree. .The age standardization prevail rate of BPH：Other area is 1011.0×10-5, Taipei is 813.8×10-5 , Kaohsjung is 740.8×10-5, Taichung is 574.7×10-5, in direct proportion with the hospital site. Cohort study and logistic regression was used to determine the relative risk of specific risk factors on prostate cancer risk. The significant risk factors and protective factors for prostate cancer in study were as follows: Living in Taipei had highter risk for prostate cancer（OR＝1.7；95%CI＝1.3－2.3）；BPH history had highter risk for prostate cancer (RR＝15.67；OR＝19.0；95%CI＝13.1－27.6). Offer the evidence of epidemiology but unable to understand that BPH rotates to the causing a disease machine of PCA .Some enviromental and life-style factors may have associated with prostate cancer risk. A better understanding about these biological mechanisms will be helpful to prevent from the development of prostate cancer in the future.