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[目的]探讨食管癌高发区上消化道癌集中高发对病因和预防的启示。[方法]分析涉县、林州、阳城、磁县1998～2002年男女性食管、贲门、非贲门胃癌的发病率。[结果]在涉县、林州、阳城、磁县,食管、贲门、非贲门胃癌发病率的合计男性高达173.5/10万～281.9/10万,女性高达111.5/10万～152.8/10万,男性占到全身恶性肿瘤的70.3%～81.1%,女性占到全身恶性肿瘤的49.3%～75.5%。但这三种癌的相对比例存在地区间差异:涉县以贲门和非贲门的胃癌多见,占上消化道癌的60%以上;而磁县以食管癌多见,占70%以上;林州和阳城食管癌和胃癌各占约50%。[结论]应该把该地域当作上消化道癌高发区来认识,在努力寻找能标定个体风险或早期事件的生物学指标的同时,通过大规模改良饮水,降低高发区人群对亚硝胺的暴露水平,也许有助于更快降低发病率。
[Objective] To explore the etiology and prevention of high incidence of upper gastrointestinal cancer in high incidence area of esophageal cancer. [Methods] The incidence of esophageal, cardia and non-cardiac gastric cancer in men and women in Shexian, Linzhou, Yangcheng and Cixian from 1998 to 2002 was analyzed. [Results] The incidence rate of total cancers in Shexian, Linzhou, Yangcheng, Cixian, esophagus, cardia and non-cardia gastric cancer was as high as 173.5 / 100,000 to 281.9 / 100,000 and in women as high as 111.5 / 100,000 to 152.8 / 100,000 , Males accounted for 70.3% ~ 81.1% of the whole body malignant tumors, and women accounted for 49.3% ~ 75.5% of the total body malignant tumors. However, the relative proportions of these three kinds of cancer ranged from one area to another: Shenshan County was predominantly gastric cancer with cardia and non-cardia, accounting for more than 60% of upper gastrointestinal cancers; while Cixian was more common with esophageal cancer accounting for more than 70% State and Yangcheng esophageal and gastric cancer each account for about 50%. [Conclusions] This area should be recognized as a high-incidence area of upper gastrointestinal cancer. While trying to find biological indicators that can be used to calibrate individual risk or early events, large-scale improvement of drinking water can reduce the risk of nitrosamines Exposure levels may help reduce morbidity rates sooner.